Apply on Employer Site

AdaptHealth · 3 months ago

Lead, RCM Specialist

United States

Full-time

Remote

Mid, Senior Level

3+ years exp

AdaptHealth is a company focused on healthcare services, and they are seeking a Lead, Revenue Cycle Management Specialist to oversee the RCM teams and improve processes. The role involves mentoring staff, handling escalated inquiries, and ensuring compliance with policies while identifying trends in insurance billing.

Health CareHospitalMedical Device

Responsibilities

Mentors guide and provide oversight assistance to the team. The majority of AdaptHealth RCM team members are located offshore

Applying subject expertise in evaluating business operations and processes

Identifying areas where technical solutions would improve business performance

Consulting across teams, providing mentorship, and contributing specialized knowledge

Demonstrated various techniques and documentation to streamline the production process

Identify team members' strengths and opportunities and report findings to supervisors

Respond to internal inquiries for coaching assistance via the subject matter expert queue, office communicator, and email

Assume responsibility for resolving team member escalations by working with multiple business partners while consistent communication is present with the member

Coach others on how to navigate through systems to find information needed for calls

As a Subject Matter Expert, assist with training new employees and assist other CSRs with problems they encountered while interacting with members over the phone; addressed escalated customer questions and concerns

Performed ad hoc deep-dive analyses for specific business problems

Training and development of team members to ensure AdaptHealth policy and protocol are being followed

Take escalated phone calls that cannot be effectively resolved by team members

Communicate with other departments, front end staff regarding billing issues and trends to work toward an account resolution and decrease insurance denial percentages within AdaptHealth

Handle all insurance payer disputes that are filtered into the department

Identify trends and root causes related to inaccurate insurance billing, and report to the manager while resolving account errors

Assists in conducting team meetings to educate on insurance guidelines, claim denials, and re-training efforts on accounts incorrectly worked

Develops and enhances the process and payer-specific work job aids and standard operating procedures

Investigate escalated insurance billing inquiries and inaccuracies and take appropriate action to resolve the account

Provides quality payer feedback to other AdaptHealth leadership

Develop and maintain a working knowledge of current AdaptHealth products and services offered by the company

Maintain patient confidentiality and function within the guidelines of HIPAA

Completes assigned compliance training and other educational programs as required

Maintains compliance with AdaptHealth’s Compliance Program

Perform other related duties as assigned

Qualification

Revenue Cycle ManagementInsurance BillingAnalytical SkillsCustomer ServiceMicrosoft OfficeTechnical AptitudeCommunication SkillsMentoringProblem Solving

Required

High School Diploma required; Associated degree preferred

Three (3) years related work experience in health care administrative, financial, insurance, customer services, claims, billing, call center, or management regardless of industry required

Two (2) exact job experience in HME, Diabetic, home medical supplies, Pharmacy, HH environment is preferred

Exact job experience is considered any of the above tasks in a Medicare-certified HME, IV, or HH environment that routinely bills insurance

Strong analytical and problem-solving skills with attention to detail

Excellent verbal and written communication

Excellent customer service skills

Proficient computer skills and knowledge of Microsoft Office

Ability to prioritize and manage multiple projects

Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction

Understanding and identifying priority orders

Extensive knowledge of products offered and the required paperwork to ensure we can bill for those products

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form