RCM Strategic Service Associate

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Requirements:

• 3-5 years of equivalent and relevant experience in RCM / process management.
• Knowledge of medical billing, front office, physician practice management and healthcare business processes and workflow.
• Understanding of medical billing/coding with an understanding of various insurance carriers, including Medicare, private HMOs and PPOs.
• Keen knowledge of RCM technical integrative workflows, process-mapping, and escalation resolution

Responsibilities:

• Serve as principle point of contact for CardioOne and practice partner technical vendor relationships, system build, exceptions in workflow and optimization opportunities.
• Ensure compliance with government and commercial payer contracts, payer relations and Athena system edits/custom rules, ACO agreements, MIPS/MACRA, coding standards, and CPT Category II quality reporting.
• Serve as an expert resource in monitoring and maintaining/exceeding RCM KPI’s in AR Management targets, Cost to Collect, Charge Entry Lag, Clinical Inbox Management, Avoidable Denials, Clean Claim Submission Rate, TOS Collections, and Net Collections Rate.