RCM Manager- Remote

***This is a fully remote position. Candidate must be able to work normal PST hours.

Support a Team of Go-Getters

Veradigm Revenue Cycle Services

With Veradigm Revenue Cycle Services (VRCS), professional billing experts help organizations ensure accurate billing and coding, and partner with them at every step of the revenue cycle. Dedicated account managers deliver a comprehensive approach for improving the financial health of any practice.

Job Summary: 

Manages an RCM team who are responsible for all related medical billing activity for the purpose of maximizing accounts receivable collections for clients. In addition to performing similar work, the Manager will oversee and ensure group productivity and performance in accordance with financial goals to ensure the health of the client's Accounts Receivable. Supports RCM Management by efficiently and effectively providing oversight and review of the team, processes and workload. 

What you will contribute: 

• Strong customer service skills for client satisfaction, health of client AR and management of RCM team members
  • answering client inquiries; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally
  • acts as primary point of contact for team members and provides guidance on work matters 

• Track clients’ AR productivity and health (charge, payments, collections, adjustments) on a daily, weekly and/or monthly basis as needed to ensure the client and company expectations are met 
• Analyze reports to determine when, how and why decrease in clients’ AR; includes denials, unbilled, credit issues, holds; determine corrective actions and communicate with client and staff to resolve.  Follow up to ensure actions are taken that achieve the results needed and/or determine other resolution needed
• Responsible for staff productivity for follow-up of all unpaid, denied, and underpaid and overpaid claims. This includes but is not limited to: contacting insurance companies for claim status, reviewing all insurance claims and patient documentation, reviewing and ensuring appropriate coding, handling correspondence, and making appropriate decisions for follow-up action. Must be effective at handling several accounts simultaneously and ensuring maximum accounts receivable and expedient collection turnaround for clients.
• Meets with Client representatives to review billing progress, status of an accounts and review and resolve any issues presented by clients.
• Ensures that staff and/or vendor, as applicable enters all charges into the medical billing system accurately and correctly for reimbursement. This includes but is not limited to: ensuring correct CPT codes, modifiers, and ICD codes, authorizations for services, patient demographics, and health insurance data.
• Responsible for staff who enter all patient, insurance, and third-party payments into the medical billing system. This includes a thorough knowledge and understanding of medical EOB’s, patient deductibles and co pays, insurance or third-party correspondence, contractual payments and adjustments.
• Interact with clients and their patients, engage in proactive resolution of issues and timely response to questions and concerns.
• Deliver timely required reports to the RCM Management; initiates and communicates the resolution of issues
• Meet regularly with staff; in-person and as a group to confirm the status of client accounts and build/sustain staff engagement to drive business results and improvements
• Remain current with company’s policies and procedures regarding AR activity such as, reviewing month end reports to ensure the AR and cash collections are meeting agreed upon benchmarks, identifying trends, reviewing denial reports
• Review work performed by outside vendors for accuracy and production.  Determine changes/improvement needed and works promptly and appropriate with applicable individuals to bring about such changes/improvement
• Achieve goals set forth by management and compliance requirements
• Follows, enforces and models adherence to all policies, procedures and processes 

The ideal candidate will have: 

• Bachelor's Degree or equivalent Technical / Business experience (Required)
• 8+ years relevant work experience; 2-3 years at the Expert level or equivalent experience (Preferred)
• Prior experience on Veradigm PM (Preferred)
• Prior experience on Practice Fusion EMR (Preferred)
• Experience working with India associates or vendor relationships (Preferred)
• 2-4 years relevant leadership experience (Preferred)