Senior RCM Process Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform comprehensive evaluations of current Revenue Cycle Management (RCM) processes at various stages, including patient registration, charge entry, claims submission, payment posting, denial management, and accounts receivable follow-up.

• Detect bottlenecks, inefficiencies, and compliance risks within RCM workflows, and recommend data-driven solutions.

• Create and execute process enhancements, standard operating procedures (SOPs), and best practices to improve RCM performance and optimize revenue generation.

• Work in collaboration with cross-functional teams such as product development, client success, and operations to implement process modifications and system upgrades.

• Design and conduct training sessions for internal teams and clients regarding updated RCM processes and system functionalities.

• Track essential RCM performance indicators (KPIs) and deliver regular reports on process effectiveness and potential areas for optimization.

• Keep informed about industry trends, regulatory updates, and technological innovations in RCM to ensure that Modernizing Medicine's solutions remain competitive and compliant.

• Engage in client-facing discussions to comprehend RCM challenges and provide expert advice on process enhancements.

• Aid in the formulation and documentation of RCM product requirements based on process evaluations and client inputs.

• Resolve complex RCM issues and offer advanced support to both internal teams and clients.

⛳️ Requirements

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related discipline.

• At least 5 years of progressive experience in Revenue Cycle Management, with an emphasis on process analysis and enhancement.

• In-depth knowledge of healthcare billing, coding (CPT, ICD-10, HCPCS), claims processing, and denial management.

• Demonstrated experience in pinpointing process inefficiencies and executing effective solutions.

• Exceptional analytical, problem-solving, and critical thinking abilities.

• Proficient in RCM software and electronic health record (EHR) systems; experience with Modernizing Medicine's products is an advantage.

• Strong communication skills (both written and verbal) and interpersonal abilities, capable of effectively engaging with all levels of staff and clients.

• Ability to work autonomously as well as collaboratively in a fast-paced, dynamic environment.

• Experience in project management or familiarity with project management methodologies is preferred.

• Certification in healthcare revenue cycle (e.g., CRCR, CHFP) is a plus.

🏝️ Benefits

• Comprehensive medical, dental, and vision benefits, along with a company Health Savings Account contribution.

• 401(k): ModMed offers a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contributions you receive are yours to retain.

• Generous Paid Time Off and Paid Parental Leave policies.

• Company-paid Life and Disability insurance benefits.

• Flexible Spending Account and Employee Assistance Programs.

• Company-sponsored Business Resource & Special Interest Groups that foster engaged and supportive communities within ModMed.

• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning.

• Global presence and opportunities for in-person collaboration; dog-friendly headquarters (US).

• Hybrid office-based roles with remote availability for certain positions.

• Weekly catered breakfast and lunch.

• Treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.