RCM Manager

GoTo Meeting; Pune District; Hybrid; INR 700,000 - 900,000; Full time

Benefits offered by this job

Quarterly Company-Wide Recharge Days

Peer-based incentive 'Cheer' awards

Tuition Reimbursement Program

Job summary

GoTo Meeting is seeking a Medical Billing Manager in Pune, India. Responsible for managing a Revenue Cycle Management (RCM) team engaged in medical billing activities aimed at maximizing client collections. This role ensures accuracy in billing processes, oversees staff productivity, and resolves client issues effectively. The ideal candidate will have strong communication skills and experience with billing systems such as NextGen and MS Excel. Benefits include tuition reimbursement and company-wide recharge days.

Qualifications

• Extensive knowledge with email, search engines, and the internet.
• Ability to effectively use payer websites.
• Intermediate practical knowledge of Microsoft products.
• Experience in specialties such as psychiatry and orthopedics.

Responsibilities

• Manage staff productivity for medical billing activities.
• Meet with client representatives to review billing progress.
• Ensure correct entries into the medical billing system.
• Proactively resolve client and patient issues.

Skills

Customer service skills

Strong communication skills

Knowledge of CPT and ICD codes

Proficient with Microsoft products

Experience with billing systems

Tools

Microsoft Excel

NextGen

LaserFiche

Crystal Reports

Job description

Job Description Summary

Manages a RCM team who are responsible for all related medical billing activity 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.

Job Description

• Responsible for staff productivity for follow‑up of all unpaid, denied, underpaid and overpaid claims. This includes but is not limited to contacting insurance companies for claim status, reviewing all insurance claims and patient documentation, 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 receivables and expedient collection turnaround for clients.
• Meets with client representatives to review billing progress, status of accounts 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 ensuring correct CPT codes, modifiers, ICD codes, authorizations for services, patient demographics, and health insurance data.
• Responsible for staff that enters all patient, insurance, and third‑party payments into the medical billing system. Requires thorough knowledge and understanding of medical EOBs, patient deductibles and copays, 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.
• 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.
• Deliver timely required reports to RCM Management; initiate and communicate 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.

Knowledge, Skills and Abilities

• Extensive knowledge with email, search engines, Internet.
• Ability to effectively use payer websites and LaserFiche.
• Intermediate practical knowledge of Microsoft products: Outlook, Word, Excel, PowerPoint.
• Preferred experience with MS Access, Crystal Reports.
• General knowledge of and ability to learn/regularly use various billing systems, EMRs and interfaces.
• Previous experience with billing systems such as NextGen, Pro, Allscripts, Epic and others.
• Accounting skills preferred.
• Knowledge of CPT, ICD10 and modifiers.
• Experience in specialties such as psychiatry, internal medicine, orthopedics, general surgery.
• Familiar with HMO and IPAs, Medicare Fee‑for‑Service plans and commercial payers.
• Strong communication skills.

Working Arrangements

• Standard work week or as defined by assignment requirements.
• Primarily works in standard office environment or remotely.
• May require after‑hours, on‑call support and/or holidays.
• On‑call and after‑hours work during peak times including end of month/quarter/year; during this time PTO is limited to meet business needs.
• 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.
• Remain current with company’s policies and procedures regarding AR activity such as reviewing month‑end reports to insure AR and cash collections are meeting agreed‑upon benchmarks, identifying trends, reviewing denial reports.
• 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.
• Review work performed by outside vendors for accuracy and production. Determine changes/improvements needed and work promptly and appropriately with applicable individuals to bring about such changes/improvements.
• Achieve goals set forth by management and compliance requirements.
• Follow, enforce and model adherence to all policies, procedures and processes.

Benefits

• Quarterly Company‑Wide Recharge Days.
• Peer‑based incentive "Cheer" awards.
• Tuition Reimbursement Program.

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