Revenue Cycle Management Specialist
3 days ago
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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