RCCEM Escalation Manager, Claim Resolution

athenahealth; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare technology company is seeking an Escalation Manager to join their Revenue Cycle Case and Escalation Management team. The role involves managing complex client issues, driving actionable insights, and collaborating cross-functionally. Ideal candidates will have a bachelor's degree and experience in medical billing or US healthcare. Strong problem-solving and project management skills are essential. This role offers an opportunity to make a significant impact in healthcare solutions.

Benefits

Innovative work environment

Diversity and inclusion commitment

Qualifications

• Ideal candidate should have medical billing or US healthcare experience.
• Demonstrated ability to rapidly learn healthcare concepts.

Responsibilities

• Manage own book of business and support team.
• Drive actionable insights across Product and Revenue Cycle Management.
• Develop and maintain client relationships.

Skills

Customer-centric mindset

Analytical problem-solving

Strong communication skills

Project management

Proficient in Excel

Education

Bachelor's degree or equivalent experience

Tools

Excel

Google tools

SharePoint

Job description

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Job Title: Escalation Manager, Enhanced Claim Resolution Management

Department: 1247 Level Three Escalations

Reports to: Merrit Neptune

Position Summary:

Join our dynamic Revenue Cycle Case and Escalation Management (RCCEM) team, where you will play a pivotal role in tackling our most complex and sensitive client issues. As the final escalation point, our team is dedicated to researching and resolving challenges that require a keen eye for detail and a commitment to excellence.

You will be at the forefront of driving actionable insights across Product and Revenue Cycle Management, ensuring that our product and services not only meet but exceed athenahealth's value proposition and the expectations of our clients. Your contributions will be essential in creating visibility into case performance, fostering consistency in terminology and measurement, and championing initiatives that enhance case resolution performance.

As an Escalation Manager, you will manage your own book of business while also supporting the team by collaborating with peers to identify and eliminate barriers to resolution and assist them in navigating high-profile escalations. You will help maintain queue health, provide tools for better management and monitoring, and leverage case data to gather and deliver actionable insights to our partner teams.

At athenahealth, we pride ourselves on our innovative spirit and solution-oriented mindset. We thrive in a collaborative environment that embraces continual change and improvement, fueled by our rapid growth. If you enjoy engaging directly with people and teams, being their partner, advocate, and coach to ensure they have the right tools, relationships and confidence to navigate the evolving landscape of issue management, this is the perfect opportunity for you to make a significant impact. Join us in shaping the future of healthcare solutions!

Essential Functions (Duties and Responsibilities):

Customer Focus

• Models the team's expectations and methodology while supporting and leading the most sensitive engagements.
• Develops and maintains professional and productive ongoing client relationships regarding service-related issues.
• Meets with clients and stakeholders weekly, biweekly, monthly, or as necessary to provide senior-level escalation engagement updates.
• Leverages strong cross-functional partnerships to advocate for changes to service delivery, service offerings, and/or product.
• Successfully balances managing individual book of business and supporting others (50/50)

Analytical Thinking

• Develops a comprehensive business case to tell the “impact story” to create a strong sense of client benefit to facilitate effective advocacy
• Leads team initiatives to improve department processes and tools.
• Drives workflow and quality improvements to reduce case inflow and improve client sentiment.
• Utilizes reporting and tools to understand and manage RCCEM book of business.

Plans and Aligns (Project Management)

• Applies comprehensive project management skills to manage project life cycle to ensure top-quality deliverables
• Ensures critical resources are aligned and coordinated across different teams.
• Supports the team in anticipating risk and contingencies as part of the planning process.
• Effectively manages the queue by assigning cases according to skill level, account ownership, and ensuring a balanced workload.

Lead Others

• Provides leadership in escalation and project management.
• Fosters team development by enhancing skills in content knowledge, de-escalation strategies, resource utilization, and creating actionable insights.
• Works collaboratively with the Senior Manager on team performance and development opportunities.

Education & Experience Required:

• An ideal candidate will have medical billing/US healthcare experience or have demonstrated the ability to rapidly learn the foundational concepts of US healthcare and medical billing.
• Bachelor's degree or equivalent experience

Knowledge & Skills:

• Customer-centric mindset characterized by empathy, collaboration, and advocacy.
• Strong written and verbal communication skills, enabling effective interaction with all organization levels and stakeholders.
• Expertise in problem-solving, with the ability to analyze large data sets to identify root causes and trends.
• Proven capability to analyze data, surface trends and insights, and provide actionable recommendations.
• Ability to work independently and as part of a team, knowing when to involve others for effective problem-solving.
• Strong project management skills, including planning and aligning tasks, resources, and timelines.
• Tenacious and accountable, able to navigate complexity and overcome obstacles.
• Proficient in Excel and other business tools (Smartsheets, Google tools, SharePoint, etc.)
• Experience with athenahealth products and services a plus

About athenahealth

Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.

Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers, and the communities where we work and serve.

We are an equal opportunity employer and welcome applications from diverse candidates.