Revenue Cycle Management Specialist

3 days ago


Deerfield Beach, Florida, United States Wolters Kluwer Full time

Job Summary

We are seeking a skilled Revenue Cycle Management Specialist to join our team at Wolters Kluwer. As a key member of the Product Management team, you will manage functional requirements and use-cases for enhancing our content, claims calculators and other software solutions.

The ideal candidate will have a strong understanding of healthcare reimbursement systems, RCM (Revenue Cycle Management) software and systems, and be proficient in analyzing CMS rules as it relates to claims and processes.

Main Responsibilities:

  • Research, analyze and interpret CMS rules and claims data to identify trends, issues, and changes.
  • Conduct data analysis to ensure our systems provide accurate and timely claim submission analysis for our clients.
  • Participate as part of a cross-functional team in developing and maintaining reports and dashboards to monitor claims performance and compliance that provide actionable insights for our customers.
  • Provide training and support to team members on OPPS and IPPS claims processes.
  • Stay updated on changes in healthcare regulations and reimbursement policies.

Requirements:

  • 3+ years as a Medicare/Medicaid Compliance Analyst - Revenue Cycle
  • 1+ years of EHR or homegrown EMR implementation experience
  • 3+ years of claim submission experience Inpatient preferrable; Outpatient required
  • 3+ years of experience writing functional requirements and creating use cases
  • 3+ years Business Analyst experience
  • Strong analytical and problem-solving skills
  • Excellent communication and interpersonal skills
  • Ability to work independently and as part of a team
  • Proficiency in data analysis tools (e.g., SQL, Excel, Tableau)
  • Recent experience with healthcare claims software (e.g., Epic, Cerner, or equivalent)

Salary Range: $90,000 - $110,000 per year



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