Revenue Cycle Management Specialist II

2 weeks ago

Tate, United States NextGen Healthcare Full time
Job Overview:
The Revenue Cycle Management Specialist II is responsible for executing tasks related to the management of revenue cycles, specifically focusing on the configuration and processing of claim submissions. This role involves collaboration with colleagues and global partner teams to address assignments and escalations within the RCM department, ensuring the efficient completion of daily, weekly, and monthly responsibilities. The Specialist will actively engage in client-focused performance initiatives and oversee the quality of work produced by global partner teams, working closely with RCM subject matter experts to identify trends and areas for improvement.
  • Efficiently manage inventory assignments with minimal supervision.
  • Support client-specific workflow processes.
  • Evaluate work quality in relation to client protocols, utilizing audit tools and documented procedures.
  • Participate in vendor management and client meetings as required by management.
  • Assist in documenting issues, trends, and performance monitoring tools for management.
  • Act as a backup to ensure continuity of work processes in the absence of global partners or assigned staff.
  • Foster positive relationships with internal and external customers, vendors, and payers by delivering exceptional customer service.
  • Uphold the confidentiality of patient information in compliance with company policies and HIPAA regulations.
  • Engage with management to provide ongoing client-specific feedback in preparation for management meetings.
  • Lead small-scale department and client-specific projects as assigned.
  • Generate standard and ad hoc reports as necessary, develop action plans, and contribute to the creation of Standard Operating Procedures (SOPs).
  • Perform additional duties that align with the overall objectives of the position.
Department-Specific Duties:
  • Collaborate with global partners to ensure timely submission of claims for clients.
  • Work with technology vendors involved in claims management.
  • Produce relevant reports for management and clients regarding claims submission and adherence to service level agreements (SLAs).
Required Education:
  • High School Diploma or General Educational Development (GED).
Required Experience:
  • 2-4 years of experience in medical billing and/or collections within a healthcare or insurance setting.
  • Alternatively, any combination of education and experience that meets the qualifications for the position.
Knowledge, Skills & Abilities:
  • Knowledge of healthcare carriers and payer requirements, proficiency in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint) at an intermediate level, and familiarity with Windows-based programs and practice management software.
  • Skills in effective communication with cross-functional teams, providing customer service to clients, problem-solving, analytical thinking, and teamwork.
  • Ability to build strong relationships, work independently with limited guidance, maintain confidentiality, thrive in a fast-paced environment, and manage multiple tasks while meeting deadlines.
NextGen Healthcare is an equal opportunity employer, committed to fostering diversity and creating an inclusive environment for all employees.

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