Requirements
Responsibilities:
Act as a primary source of knowledge for the RCM process, providing guidance and direction to the RCM team.
Analyze revenue cycle trends and work towards improving and streamlining processes.
Train team members on updated RCM procedures and guidelines.
Participate in client meetings to provide expert insight into the RCM process.
Resolve complex RCM issues that are escalated from team members.
Develop and maintain documentation of RCM procedures and guidelines.
Stay informed on changes in healthcare regulations, medical coding, and billing practices.
Collaborate with other departments to ensure the integrity of the RCM process.
Recommend process improvements to increase accuracy, efficiency, and revenue.
Ensure compliance with state and federal regulations as well as company policies.
Qualifications:
Bachelor's degree in Business, Healthcare Management, or a related field.
Minimum of 5 years of experience in healthcare RCM, with a proven track record in a similar role.
Comprehensive knowledge of medical terminology, CPT, ICD-10, and HCPCS coding.
In-depth understanding of medical billing, coding, collections, and payment posting processes.
Excellent analytical and problem-solving skills.
Strong communication skills, both verbal and written.
Proficient in MS Office Suite and medical billing software.
Experience in providing training and mentoring to team members.
Understanding of state and federal healthcare regulations, including HIPAA.
Ability to work independently, manage time effectively, and make decisions under pressure.
Certification in medical billing or coding, such as CPC, is a plus.