Senior RCM Process Specialist

ModMed•Brick, NJ

2d•Hybrid

About The Position

ModMed is hiring a driven Senior RCM Process Specialist to join our positive, passionate, and high-performing RCM (aka BOOST) Team. This individual will be a key contributor to optimizing revenue cycle management (RCM) workflows and systems. The role involves analyzing current processes, identifying areas for improvement, implementing solutions, and ensuring efficient and compliant revenue capture for our healthcare clients.

Requirements

Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.
Minimum of 5 years of progressive experience in Revenue Cycle Management, with a focus on process analysis and improvement.
Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), claims processing, and denial management.
Proven experience in identifying process inefficiencies and implementing effective solutions.
Excellent analytical, problem-solving, and critical thinking skills.
Proficiency in RCM software and electronic health record (EHR) systems; experience with Modernizing Medicine's products is a plus.
Strong communication (written and verbal) and interpersonal skills, with the ability to effectively interact with all levels of staff and clients.
Ability to work independently and as part of a team in a fast-paced, dynamic environment.

Nice To Haves

Project management experience or familiarity with project management methodologies is desirable.
Certification in healthcare revenue cycle (e.g., CRCR, CHFP) is a plus.

Responsibilities

Conduct in-depth analysis of existing RCM processes across various stages, including patient registration, charge entry, claims submission, payment posting, denial management, and accounts receivable follow-up.
Identify bottlenecks, inefficiencies, and compliance risks within RCM workflows and propose data-driven solutions.
Develop and implement process improvements, standard operating procedures (SOPs), and best practices to enhance RCM performance and maximize revenue.
Collaborate with cross-functional teams, including product development, client success, and operations, to integrate process changes and system enhancements.
Design and deliver training programs for internal teams and clients on new RCM processes and system functionalities.
Monitor key RCM performance indicators (KPIs) and provide regular reports on process effectiveness and areas for further optimization.
Stay abreast of industry trends, regulatory changes, and technological advancements in RCM to ensure Modernizing Medicine's solutions remain competitive and compliant.
Participate in client-facing discussions to understand RCM challenges and provide expert guidance on process improvements.
Assist in the development and documentation of RCM product requirements based on process analysis and client feedback.
Troubleshoot complex RCM issues and provide advanced support to internal teams and clients.

Benefits

Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation.
Generous Paid Time Off and Paid Parental Leave programs
Company paid Life and Disability benefits
Flexible Spending Account
Employee Assistance Programs
Company-sponsored Business Resource & Special Interest Groups
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
Global presence and in-person collaboration opportunities
Dog-friendly HQ (US)
Hybrid office-based roles and remote availability for some roles
Weekly catered breakfast and lunch
Treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.