Healthcare RCM Lead- Capitated Accounts

```Job Summary```
We are seeking a highly skilled and experienced RCM Lead with capitation experience to join our team. As the RCM Lead, you will be responsible for for managing all aspects of the revenue cycle, including billing, coding, and collections. A successful candidate will have a strong understanding of healthcare billing regulations, coding guidelines, and payment systems. The professional has a high level of knowledge, skill, and experience in increasingly complex areas of revenue cycle. They have a specific skillset and adhere to standards of moderately complex RCM situations.

```Responsibilities```
· Manage and oversee the revenue cycle process, from charge capture to payment posting

· Review and analyze claims for accuracy and completeness before submitting to payers

· Ensure compliance with billing and coding regulations and guidelines

· Identify and resolve issues with denied or rejected claims

· Follow up on unpaid claims and collections to ensure timely payment

· Communicate with insurance companies, patients, and other stakeholders to resolve billing and coding issues

· Work with healthcare providers to ensure accurate charge capture and documentation

· Analyze billing and payment data to identify trends and opportunities for improvement

· Collaborate with other healthcare professionals, such as physicians and nurses, to ensure efficient and effective revenue cycle management

· Stay up-to-date on changes to healthcare regulations, coding guidelines, and payment systems

· Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA)

· Other duties as assigned

```Skills```

• Bachelor's degree in healthcare administration, business administration, or a related field
• Minimum of 3 years of experience in healthcare revenue cycle management
• Strong knowledge of healthcare billing regulations, coding guidelines, and payment systems
• Excellent analytical and problem-solving skills
• Strong attention to detail and accuracy
• Ability to communicate effectively with insurance companies, patients, and other stakeholders
• Ability to work independently and as part of a team
• Proficient in Microsoft Office and other relevant software applications
• Knowledge of healthcare billing regulations, including HIPAA compliance

If you are a results-driven professional with a passion for optimizing revenue cycle operations, we would love to hear from you. Join our team as an RCM Lead and contribute to the success of our organization.

Job Type: Full-time

Pay: $65,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 10 hour shift
• 12 hour shift
• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Remote

Experience:

• RCM: 3 years (Required)

Work Location: Remote