RCM Analyst

Summary

Join a dynamic team at Modernizing Medicine as an Accounts Receivable Analyst to make a positive impact on healthcare! This key position is responsible for resolving claims with insurance balances that have no response or are being denied, working assigned claims, and running reports to identify claims that require follow-up. The ideal candidate will have 2+ years of experience in AR Follow-ups (Voice) in Physician RCM, sound knowledge of billing scrubbers and CH/Payer Rejections, and strong communication skills.

Requirements

• 2+ years of experience as AR Follow-ups (Voice) in Physician RCM is a must
• Sound knowledge of working on Billing scrubbers and CH/Payer Rejections
• Understanding of other related functions in the RCM is required
• Proven experience of good Cash collected/Resolution rate
• Strong knowledge of Commercial & Federal payers, basic Coding concepts & CARC codes
• Knowledge of working and resolving Auto, WC , IPAs etc. is required
• Expert in listening and resolving problems
• Ability to interact positively with team members, peer groups, and seniors
• Being proficient in delivering a high-quality outcome is a must
• Capable of grasping new concepts quickly; Able to comprehend various training aids and process documentation
• Excellent written and verbal communication skills
• Strong knowledge of HIPAA guidelines

Responsibilities

• Responsible for working assigned claims and running reports to identify claims that require a follow-up and resolve the denial by taking appropriate action as per Modmed guidelines
• Ensuring timely follow up to save claims from getting written off due to untimely following up
• Work on Contractual adjustments and write-off projects
• Analyze previous notes and actions taken on claims; take the correct action on claims not handled correctly previously and bring that to the knowledge of the Quality Team
• Identify opportunities to improve follow up process and recommend changes to be added/removed in the Practice Instructions or SOPs with any recent changes at the Payer end
• Attend trainings to learn new updates, technologies, and techniques; enhancing knowledge of various scenarios and keeping abreast with the new updates is an important requirement for this role
• Continuously self-audit to ensure quality standards are met
• Review claim thoroughly and explore all possibilities to get claim resolved prior to assigning claims to any other Modmed or client buckets
• Perform additional tasks or project work as assigned

Benefits

• Comprehensive benefits package including medical for you, your family, and your dependent parents
• The company supported community engagement opportunities along with a paid Voluntary Time Off day to use for volunteering in your community of interest
• Global presence, and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office based roles and remote availability
• Company-sponsored Employee Resource Groups that provide engaged and supportive communities within ModMed
• 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. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• 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