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  • Inc. 5000 Fastest-Growing Private Companies in America 2023
  • Company of the Year | 2023 BIG Innovation Awards
  • Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards

Who we are:

We Are Modernizing Medicine (WAMM)! We’re a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed is based in Boca Raton, FL, with office locations in Santiago, Chile, Berlin, Germany, Hyderabad, India, and a robust remote workforce with team members across the US.

 

ModMed is hiring a driven RCM Optimization Specialist to to join our positive, passionate, and high-performing RCM team focused on driving success, retention, and new account performance for our RCM clients. This is an exciting opportunity to help our new RCM clients get off to the right start with a fast-paced Healthcare IT company that is truly Modernizing Medicine!

Your Role:

  • Assess new client’s current workflow and consult with implementation and client advisor teams on the best approach for a successful RCM performance.
  • Review configurations and practice settings prior to going live to ensure clients' live sites are ready for success with our billing teams.
  • Review and analyze customer accounts, identify trends and issues and implement and engage support teams for solutions.
  • Monitor fee schedules and insurance denials in order to ensure fully allowed reimbursement and denial prevention strategies are implemented.
  • Provide structured feedback to the Implementation team to drive continuous improvement.
  • Review, document, and investigate accounts where billing inaccuracies were found and guide global partners and operations support with the necessary account/billing adjustments within the first 90 days of service delivery.
  • Conduct comprehensive performance audits of client practices to support best practices and optimal outcomes for all parties. This includes:
    • Monitor billing activity
    • Assessing AR follow up
    • Monitor payment posting activity
    • Payer and trend analysis
    • Meet and communicate with client management and production team to share best practice and recommend workflow changes or enforcement of standard processes
  • Ability to adapt to changing work priorities and regularly exercise independent judgment.
  • Support payer configuration activities.
  • Isolate and define trends/problems, provide alternatives or solutions, participate in group problem-solving discussions, and prioritize work.
  • Helps with auditing of new clients to assess if there are any issues or trends.
  • Communicate with our global team, internal operations, and client management team to get this resolved timely.
  • Leverage deep knowledge and understanding of clients’ key practice revenue performance metrics to drive SLA achievements, review metrics and stabilize during ramp up accordingly.
  • Ensure Client Key Performance Indicator benchmarks are met.

Skills & Requirements:

  • Bachelor's degree or equivalent experience.
  • 4 years equivalent and relevant experience in RCM / process management.
  • Knowledge of medical billing, front office, physician practice management and healthcare business processes and workflow.
  • Understanding of medical billing/coding with an understanding of various insurance carriers, including Medicare, private HMOs and PPOs.
  • Excellent written, verbal and interpersonal communication skills.
  • Strong organizational skills.
  • Should have knowledge and experience with financial reporting.
  • Demonstrated analytical thinking and problem solving ability.  Can systematically and logically work to identify causation and resolve problems.

#LI-KM1 #LI-REMOTE

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, including:

  • 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.

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