NextGen RCM Specialist

Texas Health Care C • Fort Worth, TX

1d

About The Position

This role involves collaborating with peers, offshore vendors, and senior management to meet business needs. The specialist will support physicians and care center staff with Revenue Cycle Management (RCM) questions and escalations, conduct account research and analysis, and understand payer nuances to help create payer-specific billing rules. The position requires identifying and executing process initiatives related to billing and adjustments, preparing and maintaining reports, and interacting with customers to resolve outstanding issues. Maintaining confidentiality and adhering to HIPAA guidelines are essential. Additional duties may be assigned.

Requirements

• Minimum 3 years of progressive professional experience in healthcare revenue cycle management.
• Proficient in government and commercial insurance billing and experience with working on various Clearing houses (Waystar, Trizetto, etc).
• Proficient in the use of Excel, Word, and PowerPoint or equivalent Google software.
• Knowledge and understanding of ICD-10, CPT, and HCPCS codes and payer-specific coding guidelines.
• Knowledge and understanding of medical terminology and procedures.
• Knowledge of coding, medical records, remittance codes, and reimbursement policies.
• High School diploma or general equivalency.
• Good verbal and written communication skills.
• Ability and willingness to work flexible hours to meet staffing needs.

Nice To Haves

• Minimum 3 years experience with NextGen EPM software
• Experience working on HL7 library

Responsibilities

• Work collaboratively with peers, offshore vendors, and senior management to ensure business needs are met.
• Provide support to physicians and care center staff with RCM questions or escalations.
• Conduct account research and analysis.
• Understand Payer nuances and help in creating payer-specific billing rules.
• Identify and execute necessary process initiatives related to Billing, adjustments, etc.
• Prepare and maintain various reports.
• Interact with internal and external customers to resolve outstanding issues.
• Maintain confidentiality of all information; adhere to all HIPAA guidelines/regulations.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED