Welcome to Veradigm! Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.Veradigm LifeVeradigm is here to transform health, insightfully. Veradigm delivers a unique combination of point-of-care clinical and financial solutions, a commitment to open interoperability, a large and diverse healthcare provider footprint, along with industry proven expert insights. We are dedicated to simplifying the complicated healthcare system with next-generation technology and solutions, transforming healthcare from the point-of-patient care to everyday life.For more information, please explore Veradigm.com.
What Will Your Job Look Like
RCM Manager***This is a fully onsite position in Pune, Maharashtra Office--SHIFT 7:30PM IST – 4:30AM IST***Support a Team of Go-GettersOur professional billing experts help organizations ensure accurate billing and coding, andpartner with them at every step of the revenue cycle. Dedicated account managers delivera comprehensive approach for improving the financial health of any practice.
Job Summary
Manages an RCM team who are responsible for all related medical billing activities for thepurpose of maximizing accounts receivable collections for clients. In addition toperforming similar work, the Manager will oversee and ensure group productivity andperformance in accordance with financial goals to ensure the health of the client'sAccounts Receivable. Supports RCM Management by efficiently and effectively providingoversight and review of the team, processes and workload.
What You Will Contribute
Strong customer service skills for client satisfaction, health of client AR andmanagement of RCM team members
- answering client inquiries; prompt return and follow up to all interactions;
prompt response to requests for information, both internally and externally
- acts as primary point of contact for team members and provides guidance on
work mattersTrack clients’ AR productivity and health (charge, payments, collections,adjustments) on a daily, weekly and/or monthly basis as needed to ensure the clientand company expectations are metAnalyze reports to determine when, how and why decrease in clients’ AR; includesdenials, unbilled, credit issues, holds; determine corrective actions andcommunicate with client and staff to resolve. Follow up to ensure actions are takenthat achieve the results needed and/or determine other resolution neededResponsible for staff productivity for follow-up of all unpaid, denied, and underpaidand overpaid claims. This includes but is not limited to contacting insurancecompanies for claim status, reviewing all insurance claims and patientdocumentation, reviewing and ensuring appropriate coding, handlingcorrespondence, and making appropriate decisions for follow-up action. Must beeffective at handling several accounts simultaneously and ensuring maximumaccounts receivable and expedient collection turnaround for clients.Meets with Client representatives to review billing progress, status of accounts andreview and resolve any issues presented by clients.Ensures that staff and/or vendor, as applicable, enters all charges into the medicalbilling system accurately and correctly for reimbursement. This includes but is notlimited to: ensuring correct CPT codes, modifiers, and ICD codes, authorizations forservices, patient demographics, and health insurance data.Responsible for staff who enter all patient, insurance, and third-party payments intothe medical billing system. This includes a thorough knowledge and understandingof medical EOB’s, patient deductibles and co pays, insurance or third-partycorrespondence, contractual payments and adjustments.Interact with clients and their patients, engage in proactive resolution of issues andtimely response to questions and concerns.Deliver timely required reports to the RCM Management; initiates andcommunicates the resolution of issuesMeet regularly with staff; in-person and as a group to confirm the status of clientaccounts and build/sustain staff engagement to drive business results andimprovementsRemain current with company’s policies and procedures regarding AR activity suchas, reviewing month end reports to ensure the AR and cash collections are meetingagreed upon benchmarks, identifying trends, reviewing denial reportsReview work performed by outside vendors for accuracy and production. Determinechanges/improvement needed and works promptly and appropriate with applicableindividuals to bring about such changes/improvementAchieve goals set forth by management and compliance requirementsFollows, enforces and models adherence to all policies, procedures and processes
An Ideal Candidate Will Have
Bachelor's Degree or equivalent Technical / Business experience (Required)8+ years relevant work experience; 2-3 years at the Expert level or equivalent
Experience (Preferred)
Experience working with India associates or vendor relationships (Preferred)
Benefits
2-4 years relevant leadership experience (Preferred)Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish.Quarterly Company-Wide Recharge DaysPeer-based incentive “Cheer” awards“All in to Win” bonus ProgramTuition Reimbursement ProgramTo know more about the benefits and culture at Veradigm, please visit the links mentioned below: -https://veradigm.com/about-veradigm/careers/benefits/https://veradigm.com/about-veradigm/careers/culture/Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.Thank you for reviewing this opportunity! Does this look like a great match for your skill set? If so, please scroll down and tell us more about yourself!
