Revenue Cycle Management Manager

RCM Manager

Welcome to Veradigm Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.

Veradigm Life
Veradigm is here to transform health, insightfully. Veradigm delivers a unique combination of point-of-care clinical and financial solutions, a commitment to open interoperability, a large and diverse healthcare provider footprint, along with industry proven expert insights. We are dedicated to simplifying the complicated healthcare system with next-generation technology and solutions, transforming healthcare from the point-of-patient care to everyday life.

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What will your job look like:

RCM Manager

***This is a fully onsite position in Pune, Maharashtra Office--SHIFT 7:30 PM IST – 4:30 AM IST***

Support a Team of Go-Getters

Our professional billing experts help organizations ensure accurate billing and coding, and partner with them at every step of the revenue cycle. Dedicated account managers deliver a comprehensive approach for improving the financial health of any practice.

Job Summary:

Manages an RCM team who are responsible for all related medical billing activities for the purpose of maximizing accounts receivable collections for clients. In addition to performing similar work, the Manager will oversee and ensure group productivity and performance in accordance with financial goals to ensure the health of the client's Accounts Receivable. Supports RCM Management by efficiently and effectively providing oversight and review of the team, processes and workload.

What you will contribute:

Strong customer service skills for client satisfaction, health of client AR and management of RCM team members answering client inquiries; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally acts as primary point of contact for team members and provides guidance on work matters.

Track clients' AR productivity and health (charge, payments, collections, adjustments) on a daily, weekly and/or monthly basis as needed to ensure the client and company expectations are met.

Analyze reports to determine when, how and why decrease in clients' AR; includes denials, unbilled, credit issues, holds; determine corrective actions and communicate with client and staff to resolve. Follow up to ensure actions are taken that achieve the results needed and/or determine other resolution needed.

Responsible for staff productivity for follow-up of all unpaid, denied, and underpaid and overpaid claims. This includes but is not limited to contacting insurance companies for claim status, reviewing all insurance claims and patient documentation, reviewing and ensuring appropriate coding, handling correspondence, and making appropriate decisions for follow-up action. Must be effective at handling several accounts simultaneously and ensuring maximum accounts receivable and expedient collection turnaround for clients.

Meets with Client representatives to review billing progress, status of accounts and review and resolve any issues presented by clients. Ensures that staff and/or vendor, as applicable, enters all charges into the medical billing system accurately and correctly for reimbursement. This includes but is not limited to: ensuring correct CPT codes, modifiers, and ICD codes, authorizations for services, patient demographics, and health insurance data.

Responsible for staff who enter all patient, insurance, and third-party payments into the medical billing system. This includes a thorough knowledge and understanding of medical EOB's, patient deductibles and co pays, insurance or third-party correspondence, contractual payments and adjustments.

Interact with clients and their patients, engage in proactive resolution of issues and timely response to questions and concerns. Deliver timely required reports to the RCM Management; initiates and communicates the resolution of issues.

Meet regularly with staff; in-person and as a group to confirm the status of client accounts and build/sustain staff engagement to drive business results and

improvements Remain current with company's policies and procedures regarding AR activity such as, reviewing month end reports to ensure the AR and cash collections are meeting agreed upon benchmarks, identifying trends, reviewing denial reports

Review work performed by outside vendors for accuracy and production. Determine changes/improvement needed and works promptly and appropriate with applicable individuals to bring about such changes/improvement.

Achieve goals set forth by management and compliance requirements Follows, enforces and models adherence to all policies, procedures and processes

An Ideal Candidate will have:

• Bachelor's Degree or equivalent Technical / Business experience (Required)
• 8+ years relevant work experience; 2-3 years at the Expert level or equivalent experience (Preferred)
• Experience working with India associates or vendor relationships (Preferred)
• 2-4 years relevant leadership experience (Preferred)

Benefits

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish.

Quarterly Company-Wide Recharge Days
Peer-based incentive "Cheer" awards
"All in to Win" bonus Program
Tuition Reimbursement Program

To know more about the benefits and culture at Veradigm, please visit the links mentioned below: -

Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

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