RCM Integration Director - Elevate ENT Partners
Miami Lakes, FL 33016
About the Job
Job Summary/Objective:
As the Director of RCM Integrations, you will play a key role in optimizing and integrating revenue cycle management processes for recently acquired practices. You will manage the RCM function for new practices: some will require long-term management under legacy EMR while others will be integrated quickly into the Elevate eClinicalWorks Enterprise Environment. You will also be responsible to oversee clearinghouses and third-party vendors to streamline financial workflows, increase reimbursement rates, and improve overall practice efficiency of new acquisitions. This role requires a deep understanding of RCM processes, excellent technical skills, and a proactive approach to problem-solving.
Essential Job Functions
- Integration Management:
- Serve as the primary point of contact for the integration of new acquisitions with RCM software, billing systems, and third-party vendors.
- Lead and oversee the successful configuration, implementation, and integration of RCM functionalities within eClinicalWorks.
- Work closely with IT teams and external vendors to ensure the secure and accurate transfer of data between systems.
- Troubleshoot integration issues, escalate problems when necessary, and work toward timely resolution.
- Revenue Cycle Optimization:
- Identify areas for improvement within the RCM workflow and recommend optimizations to maximize revenue capture.
- Ensure that EMRs are used to their full capacity in terms of billing, coding, claims management, and payment posting.
- Stay updated on regulatory changes, coding updates (e.g., ICD-10, CPT), and payer requirements that may impact RCM processes.
- Training and Support:
- Oversee training and technical support to billing and front-office staff on eClinicalWorks functionalities.
- Educate staff on best practices for revenue cycle management, claim submission, and denial management within eClinicalWorks.
- Reporting and Analytics:
- Generate regular and ad-hoc reports using to analyze financial performance, including claims status, accounts receivable, and revenue trends.
- Assist in developing dashboards and KPIs to monitor practice performance and identify areas needing improvement.
- Compliance and Documentation:
- Ensure adherence to HIPAA and other compliance regulations when managing patient information and financial data.
- Maintain thorough documentation of integration setups, workflows, and any customizations applied to eClinicalWorks and other EMRs (e.g., ModMed)
- Monitor system updates and changes in payer rules to keep the RCM process compliant.
Supervisory Responsibility
Integration specialists, local practices RCM manager/supervisors
Work Environment and Physical Demands
Hybrid work environment
Travel
As Needed
Required Education and Experience
· Education:
- Bachelor’s degree in healthcare administration, information technology, or a related field (preferred).
- Certifications in RCM, medical coding, or billing (e.g., CPC, CRCR) are a plus.
· Experience:
- 7+ years of experience in revenue cycle management, preferably within a healthcare setting.
- At least 2 years of hands-on experience with eClinicalWorks in an RCM role.
- Proven experience with integration and implementation of healthcare systems (especially EMRs and billing software).
· Technical Skills:
- Strong proficiency in eClinicalWorks, including EHR and PM functionalities.
- Familiarity with medical billing, coding (ICD-10, CPT), claim submission, and denial management workflows.
- Experience with API integrations, clearinghouses, and third-party systems relevant to RCM.
- Experience with ModMed and Athena EMRs a plus.
- Proficiency in Excel, SQL, or other data analysis tools.
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