Revenue Cycle Specialist

The Revenue Cycle Specialist (RCS) oversees the revenue cycle for assigned clients and is responsible to ensure clients meet targets for KPIs, retention, and time to revenue. The RCS will serve as the primary point of contact for the Sutherland Global RCM team.

This position is fully remote, however, applicants must reside in one of the following states: FL, GA, ID, IN, KS, LA, MD, MI, MN, NC, OH, PA, TN, TX, UT, VA, WY

Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Essential Functions / Tasks / Duties / Responsibilities:

• Provide guidance and education to the Sutherland team on clarifications, help items, and resolving outstanding AR
• Report monthly denial and rejection trends internally and externally and recommend process improvements to prevent future denials and rejections
• Establish and maintain system parameters that support timely submission of claims to payers resulting in payment maximization that is both efficient and effective.
• Improve operational efficiencies to include OP software performance and assist with automation initiatives
• Independently identify and resolve process shortfalls.
• Actively participate in internal RCM and Sutherland huddles
• Maintain regular contact with RCM Vendor via meetings, email, and OP messages
• Ensure all account reviews are documented in Salesforce and client specific instructions are documented on the client blueprint
• Approve and implement workflow modifications to meet client needs that may have significant financial impact to OP and/or the practice
• Identify at-risk clients and determine actions required to resolve concerns and retain clients
• Maintain expert knowledge of payer guidelines for assigned geographic areas
• Maintain functional knowledge of OP enhancements and improvements.
• Maintain up-to-date awareness of healthcare industry standards and the overall landscape of pediatric medicine
• Complete offboarding process for clients exiting RCM services

Requirements

Competencies:

• Strong knowledge of full cycle RCM, EHR systems, ICD-10 / CPT coding
• Ability to efficiently and independently manage multiple tasks
• Ability to prioritize workload
• Understand, support, enforce and comply with Company policies, procedures and Standards of Business Ethics and Conduct
• Must be comfortable working with different systems and software applications
• Ability to effectively prioritize and execute tasks while under pressure
• Strong active listening, interpersonal written and oral communication skills
• Problem solving and decision making skills
• Able to talk to speak with clients and employees in a professional, meaningful manner

Education / Professional Certifications or Licenses Required:

• College Degree, Professional Certifications and / or some combination of related experience
• CPC (a plus)

Experience Requirements:

• Minimum of 2 years of full cycle RCM, EMR, and Customer Service experience
• CPT and ICD10 knowledge
• Microsoft office
• Google Docs

Work Environment / Physical demands/ Travel Requirements:

• Long hours on computer and phone
• Minimal lifting requirements
• Travel to conferences and remote offices
• Nights and weekend as needed

Core Values:

Office Practicum seeks to hire individuals who are able and willing to embrace our company's performance based culture, as defined by our Core Values:

• We are Clinician First
• Pediatric Care is our Home
• We Deliver on our Commitments
• Our Success is Based on Results
• We Believe in the Power of Teams

We believe that consistently aligning our planning and execution with these core values will lead to long term success for both Office Practicum as well as the customers we serve.

Benefits:

Our team members enjoy a variety of benefits, including but not limited to:

• Medical, Prescription, Vision, and Dental Insurance
• Life Insurance
• 401(k) with company match
• Paid Time Off, Holidays, and Volunteer Hours
• Company Wellness Program
• Employee Assistance Program
• Short and Long Term Disability Insurance
• Pet Insurance
• Tuition Assistance Program
• Employee Recognition Program

Equal Employment Opportunity Statement:

Our company is committed to equal employment opportunity. We will not discriminate against employees or applicants for employment on any legally recognized basis ["protected class"] including, but not limited to: veteran status, uniform service member status, race, color, ancestry, pregnancy, childbirth and related medical conditions, national origin, non-job related handicap or disability, or the use of a guide or support animal, creed, religion, sex, sexual orientation, national origin, age [18 and over] - [40 or over], physical or mental disability, predisposing genetic characteristics, military status, marital status, protected action, concerted activity, or any other protected class under federal, state or local law.

Americans with Disabilities Act Statement:

Our company is committed to providing equal employment opportunities to otherwise qualified individuals with disabilities, which may include providing reasonable accommodation where appropriate. In general, it is your responsibility to notify your supervisor of the need for accommodation. Upon doing so, your supervisor may ask you for your input or the type of accommodation you believe may be necessary or the functional limitations caused by your disability. Also, when appropriate, we may need your permission to obtain additional information from your physician or other medical or rehabilitation professionals.