RCM Systems Manager

3 months ago

orlando, United States VaxCare Full time

ABOUT VAXCARE

VaxCare is a vaccine management platform that improves immunization rates and vaccine program profitability for healthcare providers. We're a team of vaccine experts, engineers, designers, and big-picture thinkers dedicated to solving the problems faced by modern healthcare practices and staff. By offering relief for headaches in our healthcare system, we work towards our vision: every person, fully vaccinated.

VaxCare has a strong history of sustained growth over the past decade. We are a top 10 buyer/biller of vaccine in the USA, but there is still so much opportunity in front of us to keep patients immunized and communities healthy. We are a selective group, looking for "A+" teammates to help us continue towards our vision.


THE POSITION

Do you want to be a part of company making real impact on the world of healthcare?

VaxCare’s RCM Team is focused on maximizing partner payments by collecting information, knowledge and money. We research claims, analyze denials and solve problems while adding value to VaxCare’s bottom line. As a result, we play an important part in the company’s rapid growth

We are searching for someone who is passionate about projects and problem solving. In this role, the ideal candidate will play a critical role managing the Eligibility and Claims Systems that drive VaxCare’s Revenue Cycle Management.


WHAT TO EXPECT IN THIS ROLE

  • Lead a team to deliver accurate eligibility and payer mapping for new customers
  • Define and document standards for VaxCare’s Eligibility and Claims Systems (RCM Systems)
  • Establish ongoing processes for maintenance of Eligibility System to ensure accuracy and visibility of eligibility responses to stakeholders
  • Lead key projects and prioritization of development work needed to maintain and enhance RCM Systems due to market dynamics
  • Train new team members on RCM Systems
  • Lead documentation of RCM Systems
  • Serve as primary point of contact and decision maker for RCM Systems issues and modifications


EXPERIENCE REQUIRED

  • 5+ years experience in Healthcare Revenue Cycle Management
  • 5+ years experience managing teams
  • Expertise in healthcare insurance eligibility with the ability to interpret eligibility requests and responses
  • Expertise in claims filing processes including coding, claims creation, and sending claims via clearinghouses
  • Expertise in claims remittance interpretation and implementation of denial management processes


Note: Team Members in this position will be responsible for implementing and acting in accordance with VaxCare’s information security policies; protecting assets from unauthorized access, disclosure, modification, destruction or interference; executing specific security processes or activities as assigned by the Information Security and/ or Privacy officers; and reporting security events or potential security risks to the organization. Team Members in this role will be involved in the processing of protected patient and/or payment information and will be responsible for ensuring the security and privacy of the information within their scope of work.

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