Essential Duties

This position includes, but is not limited to, the following essential functions:

• Liaison Activities: Serve as the primary point of contact between the healthcare organization and the outsourced RCM service provider. Facilitate effective communication and resolve any issues or discrepancies that arise.
• Performance Monitoring: Regularly review the performance metrics of the outsourced RCM services, including billing accuracy, turnaround times, collections rates, and denial management. Identify areas for improvement and collaborate with the RCM provider to implement solutions.
• Compliance and Regulation: Ensure that all RCM activities comply with relevant healthcare regulations, including HIPAA, and are in line with contractual agreements. Stay updated with changes in healthcare laws and billing practices to maintain compliance.
• Reporting: Generate and analyze reports on financial performance, billing activities, and payer trends. Present findings to management and recommend strategies to enhance revenue and reduce inefficiencies.
• Stakeholder Communication: Coordinate with internal departments, such as clinical teams, patient services, and finance, to ensure a cohesive approach to RCM. Provide updates on RCM performance and initiatives.
• Training and Support: Offer guidance and support to internal staff on RCM-related matters. Facilitate training sessions as needed to improve understanding of billing processes and compliance requirements.
• Project Management: Participate in RCM projects, such as system implementations or process optimizations. Ensure projects are completed on time and within budget.
• Other duties as needed

Knowledge, Skills, and Abilities

• Strong understanding of medical billing processes, coding, healthcare regulations, and insurance guidelines.
• Excellent communication, negotiation, and problem-solving skills.
• Ability to analyze financial data and generate actionable reports.
• Proficient in healthcare billing software and Microsoft Office Suite.
• Excellent written and verbal communication skills
• Analytical ability to develop and implement improvements or recommendations
• An initiative-taking problem solver. Ability to understand and deal effectively with issues and opportunities
• Ability to communicate effectively with co-workers and management about the finances of the business and justify certain financial recommendations
• Builds and develops internal and external relationships, creates partnerships, builds trust, share ideas, and accomplishes work
• Embraces change and sets goals that align with the company's vision

Physical Demands

These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of this position. While performing the responsibilities, the employee is required to talk and hear. The employee is often required to sit and use their hands and fingers, to handle or feel and to manipulate keys on a keyboard. The employee is often required to stand, walk, reach with arms and hands, climb or balance, and to stoop, kneel, crouch or crawl. Vision abilities required by this job include close and distant vision. The employee must be able to travel between locations, and occasionally attend seminars which may require an overnight stay.

Working Conditions

Working conditions are normal for an office environment. The noise level in the work environment is usually quiet to moderate. May require occasional travel to meet with outsourced RCM providers or attend industry events.

Requirements/Qualifications

The person in this position will have the following experience and attributes:

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.
• Proven experience in revenue cycle management, medical billing, or a similar role within a healthcare setting.

Reasonable accommodations may be made to enable individuals to perform the essential functions of the position.