RCM Process Specialist

ModMed is hiring a driven RCM Process Specialist to join our positive, passionate, and high-performing Revenue Cycle Management team focused on evaluating incoming requests, cases, or incidents to ensure timely and effective resolution. This is an exciting opportunity to work within a fast-paced Healthcare IT company that is truly Modernizing Medicine!

Your Role:

• Review and assess the incoming requests or cases. Use established criteria to prioritize issues based on severity and impact.
• Maintain and update BOOST resources as it relates to Best Practices and Practice Instructions.
• Maintain clear and effective communication with internal teams regarding directives that might not need operational support and or self serve options. Provide updates, gather additional information, and ensure stakeholders are informed of resolution progress.
• Complete tasks necessary to support the business.

Skills & Requirements:

• Associates Degree preferred
• 2 years of previous RCM experience.
• Attention to detail and decision-making abilities.
• Experience with advanced data analysis tools and reporting software (i.e. Power BI).
• Exceptional written, verbal and interpersonal communication skills required.
• Knowledge of medical billing/coding, front-office, physician practice management and healthcare business processes.
• Strong understanding of various insurance carriers, including Medicare, private HMOs, and PPOs.
• Ability to manage and integrate information located in multiple software systems.
• Experience working with global vendors preferred.

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