Address
Form of workOverview:
Minimum Education
Required:
Minimum Experience
Required:
Knowledge Skills and Abilities
This role will partner with business leaders to improve and deliver positive change throughout all revenue cycle processes. This role will collaborate with the RCM supervisor, RCM Sr. Mgr./Mgr. to review the quality, efficiency, and productivity of our vendor partners. The Sr. RCM Specialist will work to improve the accuracy and effectiveness of revenue cycle processes through leading account audits, data analysis, training sessions, and team/vendor meetings, to name a few. This position will also be responsible for maintaining ATI’s policies and procedures as it relates to their focused area within the revenue cycle. This role will be the subject matter expert in their focused area of the revenue cycle and collaborate with other process leaders to resolve process breakdowns.
Responsibilities: - Assist in the summarizing of audit data to identify process improvement opportunities and creating Service Level Agreement (SLA) quality reporting.
- Provide ongoing monitoring of standards by conducting audits of all revenue cycle processes, vendors, and technology. Performs timely reviews of patient accounts and remittances for denials to determine root cause and appropriateness of actions, and leads corrective action plans
- Provide subject matter guidance to ATI team members and offshore vendor partner teams.
- Prepares, schedules, and leads collaboration / training sessions for onshore and offshore team members in conjunction with the RCM Supervisor to address quality concerns or optimize revenue cycle processes.
- Monitor KPI & SLA metrics to ensure department is achieving monthly/quarterly/yearly targets. Works with RCM Supervisor to develop performance improvement plans for offshore vendor partners to optimize projects
- Develops detailed and summary reports on a regular basis, which are specific to revenue cycle process and key indicators
- Responsible for maintaining all policies and standard operating procedures to improve efficiencies, leading to updates to the audit tools
- Stay current with and ensure adherence to payor guidelines, policies, and regulations, continuously monitoring changes and updates to maintain compliance and optimize revenue cycle management. Responsible for communicating with payors.
Measurable Scope and Accountability
The Sr. RCM Specialist will need understanding of all revenue cycle processes but will be assigned to one of the following focused areas: Financial Clearance, Central Business Office, Commercial/Gov’t/SP AR Follow-up, or WC/API AR Follow-up.
The Sr. RCM Specialist will need understanding of all revenue cycle processes but will be assigned to one of the following focused areas: Financial Clearance, Central Business Office, Commercial/Gov’t/SP AR Follow-up, or WC/API AR Follow-up.
Minimum Education
Required:
- High School Diploma, GED, or suitable equivalent
- Associate / bachelor’s degree
Minimum Experience
Required:
- 5 years of healthcare experience in clinical or office setting
- 3 years of healthcare revenue cycle experience
- Offshore revenue cycle vendor experience
- 5+ years of healthcare revenue cycle experience
- Experience in service line of RCM
- Data analyst experience
- Physical Therapy RCM experience
- Lead Claim, Denial, and/or process auditing teams
Knowledge Skills and Abilities
- Excellent in Microsoft Office applications, capable of creating detailed analyses using pivot tables and other formulas/features within Excel.
- Strong attention to detail to ensure the accuracy of data with the patient account.
- Ability to prioritize and manage multiple tasks simultaneously.
- Excellent interpersonal and communication skills, both oral and written
- Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy.
