Revenue Cycle Management
12 hours ago
The Revenue Cycle Management (RCM) Senior Associate role supports end-to-end revenue cycle processes, from claim submission to reimbursement. This position helps maximize revenue collection, maintain compliance, and enhance operational efficiency across multi-state operations.
Responsibilities- 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 the 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
- 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
- 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
- Employment type: Full-time
- Job function: Accounting/Auditing and Finance
- Industries: Technology, Information and Internet
Note: This refinement removes unrelated postings and extraneous content while preserving the core role information.
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