Revenue Cycle Management
4 days ago
The RCM Senior Associate plays a key role in ensuring timely and accurate execution of the end-to-end revenue cycle processes, from claim submission to reimbursement. This role supports both routine and strategic RCM functions, helping to maximize revenue collection, maintain compliance, and enhance operational efficiency across multi-state operations.
QualificationsRequired:
Bachelors degree in Accounting, Finance, Healthcare Administration, or related field
Minimum of 2 years hands-on experience in US Healthcare Revenue Cycle Management , including claims preparation, billing, denial management, and payer communication
Strong understanding of payer guidelines and revenue cycle processes
Proficient in Microsoft Office (Excel, Word, Outlook)
Strong written and verbal communication skills
Proven ability to apply critical thinking and problem-solving in complex billing scenarios
Preferred:
Experience with Practice Management Systems (e.g., Avatar, Catalyst, PCMS, Therap, Rethink)
Familiarity with RCM tools and platforms (e.g., Ability/Inovalon, Netsmart)
Prior experience handling multi-state RCM processes or working with diverse insurance carriers
Strong analytical, investigative, and reporting skills
Prepare and submit clean claims to insurance payers and clients via electronic and paper methods
Track and monitor claim submissions; resolve pre-bill edits and claim rejections in a timely manner
Process corrected and rebilled claims; manage denials and appeals to ensure timely reimbursement
Conduct A/R follow-ups and manage collection of outstanding medical accounts
Coordinate and execute mass appeal projects with various payers
Identify and resolve discrepancies in billing, payments, or account balances
Process patient and payer refunds accurately with supporting documentation
Support seamless integration of RCM data into business intelligence platforms (e.g., DOMO)
Generate and analyze key RCM performance metrics, month-end summaries, and financial reports
Ensure adherence to payer-specific guidelines and regulatory requirements across multiple states
Collaborate with internal teams and stakeholders to resolve account and data issues
Maintain up-to-date knowledge of reimbursement practices and industry changes
Deliver excellent internal and external customer service
Perform additional RCM-related duties as assigned
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