Job Description Summary:ModMed is hiring a driven Senior RCM Process Specialist to join our positive, passionate, and high-performing RCM (aka BOOST) Team. This individual will be a key contributor to optimizing revenue cycle management (RCM) workflows and systems. The role involves analyzing current processes, identifying areas for improvement, implementing solutions, and ensuring efficient and compliant revenue capture for our healthcare clients.
Your Role:- Conduct in-depth analysis of existing RCM processes across various stages, including patient registration, charge entry, claims submission, payment posting, denial management, and accounts receivable follow-up.
- Identify bottlenecks, inefficiencies, and compliance risks within RCM workflows and propose data-driven solutions.
- Develop and implement process improvements, standard operating procedures (SOPs), and best practices to enhance RCM performance and maximize revenue.
- Collaborate with cross-functional teams, including product development, client success, and operations, to integrate process changes and system enhancements.
- Design and deliver training programs for internal teams and clients on new RCM processes and system functionalities.
- Monitor key RCM performance indicators (KPIs) and provide regular reports on process effectiveness and areas for further optimization.
- Stay abreast of industry trends, regulatory changes, and technological advancements in RCM to ensure Modernizing Medicine's solutions remain competitive and compliant.
- Participate in client-facing discussions to understand RCM challenges and provide expert guidance on process improvements.
- Assist in the development and documentation of RCM product requirements based on process analysis and client feedback.
- Troubleshoot complex RCM issues and provide advanced support to internal teams and clients.
Skills & Requirements- Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.
- Minimum of 5 years of progressive experience in Revenue Cycle Management, with a focus on process analysis and improvement.
- Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), claims processing, and denial management.
- Proven experience in identifying process inefficiencies and implementing effective solutions.
- Excellent analytical, problem-solving, and critical thinking skills.
- Proficiency in RCM software and electronic health record (EHR) systems; experience with Modernizing Medicine's products is a plus.
- Strong communication (written and verbal) and interpersonal skills, with the ability to effectively interact with all levels of staff and clients.
- Ability to work independently and as part of a team in a fast-paced, dynamic environment.
- Project management experience or familiarity with project management methodologies is desirable.
- Certification in healthcare revenue cycle (e.g., CRCR, CHFP) is a plus.
ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
United States- Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,
- 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
- Generous Paid Time Off and Paid Parental Leave programs,
- Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
- Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
- Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
- Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
- Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
