RCM Specialist Home Health & Hospice Team Leader

HealthRev Partners • Stuart, FL

28d • $58,000 - $60,000

About The Position

The RCM Specialist serves as a seasoned expert in revenue cycle management, playing a pivotal role in optimizing the organization's financial performance. They possess in-depth knowledge of revenue cycle processes, insurance billing regulations, and coding guidelines. Their expertise is instrumental in resolving complex claims issues, ensuring accurate reimbursement, and maximizing revenue.

Requirements

• 5+ years of experience in revenue cycle management or a related field, with demonstrated expertise in resolving complex claims issues specifically in a home health & hospice industry
• Proficient in Microsoft Office Suite.
• Proficient in home health and hospice electronic health records (EHR) systems, and revenue cycle management software
• Proficient in Part B billing.
• In-depth understanding of insurance billing and coding procedures, including ICD-10-CM and CPT codes
• Exceptional communication, problem-solving, and analytical skills
• Proven ability to work independently and as part of a team
• Demonstrated leadership skills and the ability to mentor and train others

Nice To Haves

• Bachelor's degree in healthcare administration, business administration, or a related field preferred

Responsibilities

• Serves as the primary point of contact for assigned clients, managing their RCM business and addressing concerns.
• Conducts regular focus meetings with clients (following HRP designated process) to review performance, discuss challenges, and identify opportunities for improvement.
• Lead and mentor RCM team members, providing guidance for day-to-day questions and training on revenue cycle processes and procedures as needed.
• Helps resolve complex claim issues and member escalations.
• Analyze and resolve highly complex claims denials and appeals, advocating for the organization's reimbursement claims.
• Conduct in-depth investigations into patient billing discrepancies and disputes, ensuring timely resolution and client satisfaction.
• Develop and implement strategies to improve revenue cycle efficiency and reduce claim denials.
• Assists with revenue cycle audits and compliance reviews, ensuring adherence to regulatory standards.
• Maintain accurate and up-to-date documentation of all claims and patient accounts in clearinghouse, EMR, and Velocity.
• Monitors productivity expectations for the team based on Medicare and Non-Medicare claims worked expectations.
• Identifies opportunities for process optimization with the RCM department.
• Contribute to the development and implementation of revenue cycle management policies and procedures as needed.
• Serves as a subject matter expert for RCM claims management for assigned accounts.
• Collaborates with internal and external stakeholder to improve overall claim and collections AR performance.
• Stay abreast of changes in insurance billing regulations and coding guidelines, ensuring the organization's compliance.

Benefits

• Competitive salary and comprehensive benefits package, including health insurance, dental insurance, vision insurance, front loaded paid time off, and retirement savings plan
• Opportunity to work in a dynamic and growing healthcare organization, making a significant impact on its financial success
• Professional development and training opportunities, including conferences, webinars, and certifications
• Recognition and rewards for outstanding performance and contributions to the organization's goals

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level