RCM Process Specialist

Summary

Join ModMed's RCM BOOST team as a driven RCM Process Specialist! You will streamline the ticketing review process, improve operational efficiency, and allocate resources effectively. This crucial role enhances service quality and operational performance within a fast-paced Healthcare IT company. Review and assess incoming requests, prioritize issues, maintain BOOST resources, communicate with internal teams, provide updates, and complete tasks to support the business. The ideal candidate possesses an Associate's Degree in healthcare studies (preferred), 2+ years of relevant experience (2+ years of RCM experience preferred), and strong analytical and communication skills. ModMed offers a competitive benefits package, including health insurance, retirement benefits, paid time off, and professional development opportunities.

Requirements

• Attention to detail and decision-making abilities
• Experience with JIRA, along with advanced data analysis tools and reporting software (i.e. Power BI)
• Exceptional written, verbal and interpersonal communication skills required
• Knowledge of medical billing/coding, front-office, physician practice management and healthcare business processes
• Strong understanding of various insurance carriers, including Medicare, private HMOs, and PPOs
• Ability to manage and integrate information located in multiple software systems
• Self-motivated; takes initiative
• Capability to efficiently complete tasks in a fast paced environment
• Ability to work independently as well as part of a large RCM team
• Professional, patient and balanced approach to handling tasks of varying priority levels

Responsibilities

• Review and assess the incoming requests or cases and use established criteria to prioritize issues based on severity and impact
• Maintain and update BOOST resources as it relates to Best Practices and Practice Instructions
• Maintain clear and effective communication with internal teams regarding directives that might not need operational support and or self serve options
• Provide updates, gather additional information, and ensure stakeholders are informed of resolution progress
• Complete tasks necessary to support the business

Preferred Qualifications

• Associate’s Degree in healthcare studies preferred
• 2+ years of experience in a similar role; 2+ years of RCM experience preferred
• Experience working with global vendors

Benefits

• Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees
• Annual wellness allowance to support your well-being and productivity
• Earned, casual, and sick leaves to maintain a healthy work-life balance
• Bereavement leave for difficult times and extended medical leave options
• Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave
• Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind
• 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