A career in our Managed Services team will provide you an opportunity to collaborate with a wide array of teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology. Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients' revenue cycle functions. We specialize in front, middle and back office revenue cycle functions for hospitals, medical groups, and other providers.

Responsibilities:

• Performs quality control audits; reviews and monitors accounts
• Identifies problems, analyzes cause and effect, and suggests recommendations for improvement
• Provides daily constructive feedback based on account notation
• Identifies areas of weakness and communicates recommendations on changes and improvement to Continuous Improvement Specialists
• Document findings of analysis
• Supports company compliance by demonstrating adherence to all relevant compliance policies and procedures
• Consults and collaborates with Continuous Improvement Specialist to identify and assess training needs based on work audited
• Participate in quality control meetings

Required Knowledge and Skills:

• Good analytical and math skills
• Able to document problems and assist in their resolution
• Demonstrated ability exceeding all established department/client quality and productivity standards
• Proven ability to lead by example and foster mentoring relationships
• Strong written and oral communication skills
• Computer and internet literate in an MS Office environment
• US Healthcare Commercial and Managed Care Insurance Claim Management/Billing/Claim Edit Resolution
• US Healthcare Medicare and Medicaid Insurance Claim Management/Billing/Claim Edit Resolution
• US Healthcare Denials Management (technical and clinical)
• US Healthcare Underpayment/Payment Variance Management

Desired Knowledge / Skills:

• Quality Assurance
• HIPAA Privacy and Security Regulations with payer knowledge
• Epic Resolute, HB and PB Patient Accounting
• Cerner RevElate Patient Accounting
• Meditech Patient Accounting

Professional and Educational Background:

• High school diploma or GED required; Associates Degree preferred
• Medical Billing Certification preferred
• Minimum 2-4 years of experience in medical collections, billing, and/or claims

Additional Information: Travel to client locations may be required as per project requirements.