Sr RCM Specialist

ATI Health; Downers Grove (IL); On-site; USD 34,343 - 42,939; Full time

Job summary

A healthcare organization based in Downers Grove, Illinois is seeking a Senior RCM Specialist to enhance revenue cycle processes. The ideal candidate will have significant experience in healthcare revenue cycles, conduct audits, and offer training. Responsibilities include improving efficiency, monitoring performance metrics, and ensuring compliance with payor guidelines. A commitment to detail and excellent communication skills are necessary for this virtual position. The salary range is $24.93-$31.17 per hour.

Qualifications

• 5 years of healthcare experience in a clinical or office setting.
• 3 years of healthcare revenue cycle experience.
• Offshore revenue cycle vendor experience.

Responsibilities

• Assist in summarizing audit data to identify process improvement opportunities.
• Conduct audits of revenue cycle processes and vendors.
• Prepare and lead training sessions for team members.

Skills

Microsoft Office applications

Data analysis

Interpersonal communication

Attention to detail

Organizational skills

Education

High School Diploma

Associate / Bachelor’s degree

Job description

Overview

As the Senior RCM Specialist, you will partner with business leaders to improve and deliver positive change throughout all revenue cycle processes. This role will collaborate with the RCM supervisor, RCM Sr. Mgr./Mgr. to review the quality, efficiency, and productivity of our vendor partners.

The Sr. RCM Specialist will work to improve the accuracy and effectiveness of revenue cycle processes through leading account audits, data analysis, training sessions, and team/vendor meetings, to name a few. This position will also be responsible for maintaining ATI’s policies and procedures as it relates to their focused area within the revenue cycle.

This role will be the subject matter expert in their focused area of the revenue cycle and collaborate with other process leaders to resolve process breakdowns.

Responsibilities

Measurable Scope and Accountability

The Sr. RCM Specialist will need understanding of all revenue cycle processes but will be assigned to one of the following focused areas: Financial Clearance, Central Business Office, Commercial/Gov’t/SP AR Follow-up, or WC/API AR Follow-up.

• Assist in summarizing audit data to identify process improvement opportunities and create Service Level Agreement (SLA) quality reporting.
• Provide ongoing monitoring of standards by conducting audits of all revenue cycle processes, vendors, and technology. Perform timely reviews of patient accounts and remittances for denials to determine root cause and appropriateness of actions, and lead corrective action plans.
• Provide subject matter guidance to ATI team members and offshore vendor partner teams.
• Prepare, schedule, and lead collaboration/training sessions for onshore and offshore team members in conjunction with the RCM Supervisor to address quality concerns or optimize revenue cycle processes.
• Monitor KPI & SLA metrics to ensure the department is achieving monthly/quarterly/yearly targets. Work with RCM Supervisor to develop performance improvement plans for offshore vendor partners to optimize projects.
• Develop detailed and summary reports on a regular basis, specific to revenue cycle process and key indicators.
• Maintain all policies and standard operating procedures to improve efficiencies, leading to updates to the audit tools.
• Stay current with and ensure adherence to payor guidelines, policies, and regulations, continuously monitoring changes and updates to maintain compliance and optimize revenue cycle management. Communicate with payors.

Qualifications

Minimum Education Required

• High School Diploma, GED, or suitable equivalent

Preferred

• Associate / bachelor’s degree

Minimum Experience Required

• 5 years of healthcare experience in clinical or office setting
• 3 years of healthcare revenue cycle experience
• Offshore revenue cycle vendor experience

Preferred

• 5+ years of healthcare revenue cycle experience
• Experience in service line of RCM
• Data analyst experience
• Physical Therapy RCM experience
• Lead Claim, Denial, and/or process auditing teams

Knowledge Skills and Abilities

• Excellent in Microsoft Office applications, capable of creating detailed analyses using pivot tables and other formulas/features within Excel.
• Strong attention to detail to ensure the accuracy of data with the patient account.
• Ability to prioritize and manage multiple tasks simultaneously.
• Excellent interpersonal and communication skills, both oral and written.
• Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy.

Virtual Employee? Yes

Salary Range $24.93-$31.17 per hour