RCM Manager- Remote - Veradigm : Job Details

Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today's healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people. ***This is a fully remote position. Candidate must be able to work normal PST hours.Support a Team of Go-GettersVeradigm 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)

Enhancing Lives and Building Careers Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more? Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings. We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19. Visa Sponsorship is not offered for this position. At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings. Veradigm's policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce. From a VEVRAA Federal Contractor We request Priority Referral of Protected Veterans This is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site. Thank you for reviewing this Veradigm opportunity. Does this look like a great match for your skill set? If so, scroll on down and tell us more about yourself!