RCM Team Lead

LE9220 Veradigm India Private Limited - Pune; Pune District; On-site; INR 350,000 - 500,000; Full time

Benefits offered by this job

Quarterly Company-Wide Recharge Days

Peer-based incentive “Cheer” awards

Tuition Reimbursement Program

Job summary

Veradigm India Private Limited in Pune seeks an AR Specialist to ensure accurate and timely accounts receivable processing within Revenue Cycle Services. You will resolve billing issues, follow up on claims and patient payments, and maintain compliant billing records.

As the team SME, you will train new hires, monitor performance, generate productivity reports, escalate issues, and support management in AR process improvements for client accounts.

Responsibilities

• Promptly responds to internal and external client inquiries, interactions, and requests for information.
• Acts as the initial point of contact for team members regarding technical work questions, processes, and procedures and provides guidance on work matters.
• Escalates issues to RCS Management related to clients and staff.
• Monitors and manages accounts receivable (AR) to ensure timely claim resolution.
• Organizes, identifies and improves workflow with team members and management through daily and weekly productivity reports.
• Escalates challenges, concerns, and needs for assistance to RCS Management.
• Maintains the ability to perform the duties of the Payment Entry Specialist, Charge Entry Specialist, and/or AR Specialist.
• Serves as the team's subject matter expert regarding the claims process, complex claims, AR issues, and claims software.
• Monitors team productivity and generates reports on team performance.
• Assists management in identifying performance issues.
• Trains new hires and answers questions from less experienced associates.
• Assists with implementing new clients and offboarding client terminations.
• Reconciles account discrepancies by investigating documentation, issuing credit memos, and processing adjustments.
• Maintains accurate financial records and prepares reports on the status of the AR.
• Monitors and reconciles claims, including held vouchers, unbilled vouchers, denial trends, patient balance report, credits, and refunds.
• Effectively handles complex payer denials.
• Processes and pays secondary claims.
• Communicates with clients and medical insurance carriers to resolve billing queries.
• Assists with financial audits by providing necessary documentation and explanations for AR processes.
• Implements process improvements to enhance the efficiency of the AR cycle.

Job description

JOB SUMMARY

Ensures the accurate and timely execution of accounts receivable processes within the Revenue Cycle Services team with the goal of maximizing accounts receivable collections for Veradigm's clients. Executes accounts receivable processes and serves as a subject matter expert for the team to resolve complex accounts receivable issues. Maintains accurate and up-to-date billing records, follows up on outstanding medical billing claims and patient payments, and resolves billing issues. Works closely with other team members to ensure that payments are collected in a timely manner and that financial records are kept in strict compliance with company and client policies and regulations. Assists management in evaluating team members' performance and identifying training needs.

ESSENTIAL FUNCTIONS/MAJOR JOB RESPONSIBILITIES

• Promptly responds to internal and external client inquiries, interactions, and requests for information.
• Acts as the initial point of contact for team members regarding technical work questions, processes, and procedures and provides guidance on work matters.
• Escalates issues to RCS Management related to clients and staff.
• Monitors and manages accounts receivable (AR) to ensure timely claim resolution.
• Organizes, identifies and improves workflow with team members and management through daily and weekly productivity reports.
• Escalates challenges, concerns, and needs for assistance to RCS Management.
• Maintains the ability to perform the duties of the Payment Entry Specialist, Charge Entry Specialist, and/or AR Specialist.
• Serves as the team's subject matter expert regarding the claims process, complex claims, AR issues, and claims software.
• Monitors team productivity and generates reports on team performance.
• Assists management in identifying performance issues.
• Trains new hires and answers questions from less experienced associates.
• Assists with implementing new clients and offboarding client terminations.
• Reconciles account discrepancies by investigating documentation, issuing credit memos, and processing adjustments.
• Maintains accurate financial records and prepares reports on the status of the AR.
• Monitors and reconciles claims, including held vouchers, unbilled vouchers, denial trends, patient balance report, credits, and refunds.
• Effectively handles complex payer denials.
• Processes and pays secondary claims.
• Communicates with clients and medical insurance carriers to resolve billing queries.
• Assists with financial audits by providing necessary documentation and explanations for AR processes.
• Implements process improvements to enhance the efficiency of the AR cycle.

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
• Tuition Reimbursement Program

ABOUT US

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

Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.