Revenue Cycle Specialist, Gastroenterology - Modernizing Medicine Inc

ModMed is hiring a driven Revenue Cycle Specialist, internally referred to as an "RCM Client Advisor," to join our positive, passionate, and high-performing RCM (aka BOOST) Team. In this client-facing role, you'll be responsible for managing the client relationship, revenue cycle activities, and performance of your assigned medical practices to ensure a successful client experience. The RCM Client Advisor collaborates with our internal RCM operations team and global partners to ensure healthy Accounts Receivable and the achievement of our clients' RCM key performance indicators (KPIs) and goals. This is an exciting opportunity to leverage your RCM expertise to impact the revenue performance of medical practices.

Your Role:

• Serve as the primary point of contact for ModMed's RCM clients, managing and monitoring their end-to-end revenue cycle management processes.
• Analyze A/R data to identify payer, denial, and coding trends. Develop action plans to increase revenue and improve workflows.
• Develop and maintain strong client relationships to understand their unique RCM needs and challenges and ensure Client Key Performance Indicator benchmarks are met.
• Provide a high-level of value and customer service to both our client practices and their patients by identifying and efficiently resolving insurance and other billing-related issues.
• Establish, implement and manage Practice Performance Plans that identify, quantify and resolve issues that are impacting service levels and/or delivery of contractual obligations, as needed.
• Conduct routine audits and client meetings to review business metrics, progress, and other proactive topics to ensure high-quality delivery of contracted services.
• Collaborate with the internal RCM operations team to ensure seamless service delivery.
• Review and analyze customer accounts; identify trends and issues, recommend and implement solutions and see through to a successful resolution.
• Work closely with global partners to coordinate and optimize RCM processes and improve overall client metrics.
• Manage and escalate complex issues to the appropriate internal teams or global partners for resolution.
• Maintain knowledge of current healthcare industry and specialty-related changes and keep abreast with ModMed software enhancements and releases.
• Promote collaborative relationships with operational leadership and on and offshore partners.
• Participate in sales calls as needed to demonstrate depth of domain expertise.
• Perform additional projects and job duties as assigned.

Skills & Requirements:

• Bachelor's Degree preferred and/or training or equivalent combination of education and experience.
• 3+ years of experience overseeing the entire revenue cycle management process for medical practices, including analyzing AR, denial trends, and payer issues, and developing and presenting key performance indicators (KPIs) and reports related to revenue cycle management (required).
• Proven experience in an RCM client-facing role preferred.
• Extensive knowledge of medical billing/coding, front-office, physician practice management, and healthcare business processes.
• Advanced Excel skills such as the ability to use formulas to analyze data, create tables and pivot tables, formatting and conditional formatting.
• Strong analytical and problem-solving skills required.
• Exceptional written, verbal and interpersonal communication skills required.
• Excellent client-facing and presentation skills.
• Ability to manage and integrate information located in multiple software systems.
• Strong understanding of various insurance carriers, including Medicare, private HMOs, and PPOs.
• Professional demeanor required.

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