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 Life
Veradigm 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 Team Lead
***This is a fully onsite position in Pune, Maharashtra Office.***
Our professional billing experts help organizations ensure accurate billing and coding, and
partner with them at every step of the revenue cycle. Dedicated account managers deliver
a comprehensive approach for improving the financial health of any practice.
Job Summary
Responsible to know and facilitate specific accounts and their unique attributes in order to
successfully provide customized Our organizations RCS for each account. This is a dual
position with its own workload along with oversight to train, audit and monitor the group for
accurate procedures and turnaround. Ensure workflow, including collecting payments
stays current and on track with regards to insurance carriers, patients, clients and internal
interactions. Supports the overall Operations and Client Services by efficiently and
effectively providing and reviewing account data needed for the Revenue Cycle process
and delivering results.
What you will contribute:
- Strong customer service skills for client satisfaction, health of client AR and
guidance for RCS team members
- Answers client calls; prompt return and follow up to all interactions; prompt
response to requests for information, both internally and externally.
- Acts as initial point person for team regarding technical work
questions/processes/procedures to provide training/guidance.
- Escalates issues to RCS Management related to clients and staff.
- Trains individuals on systems and workflow in order to ensure protocols are
followed.
- Reviews and work all unpaid and denied insurance correspondence, both phone
appeals and written appeals; confirm all patient demographics and insurance is
current and up to date.
- Runs, reviews and works unpaid patient balance reports for payment by reading
current notes and place for past due letters and phone calls.
- Prepares insurance/patient correspondence for coworkers by reviewing and
batching for further attention and review.
- Prepares and sends uncollected patient payments to collections by writing up forms
for the doctors to review.
- Reviews and works insurance and patient overpayments, prepare refund request
and send to doctors office.
- Answers phone calls from insurances and patients.
- Organizes, identifies and improves workflow with team members/Management
through daily and weekly productivity reports and reports challenges and concerns
and requests need for assistance to RCS Management.
- Ability to perform the duties of the Payment Entry Specialist, Charge Entry
Specialist, AR Specialist and RCM Specialist roles.
- Keeps manager informed of progress, achievements and issues; assist staff with
processes, information and workload.
- Achieve goals set by management and compliance requirements.
- Follows, and models adherence to all policies, procedures and processes.
- Other duties as assigned.
An Ideal Candidate will have:
Job Requirements
- 3+ years relevant work experience (Preferred)
Compliance
Job responsibilities include fostering the Company s compliance with all applicable laws
and regulations, adherence to the Code of Conduct and Compliance Program
requirements, policies and procedures. Compliance is everyone s responsibility.
Knowledge, Skills and Abilities
- Knowledgeable of CPT and ICD coding and medical terminology
- Extensive knowledge with email, search engines, Internet, ability to effectively use
payer websites and Laserfiche; basic competence in use of Microsoft products.
- Preferred experience with MS Access and PowerPoint, Crystal reports and various
billing systems, such as NextGen, Pro, Epic and others
- Knowledge of CPT, ICD10 and modifiers.
- Experience in specialties such as Psychiatry, Internal Medicine, Orthopedics,
General Surgery
- Familiar with HMO and IPAs, Medicare Fee for Service Plans and Commercial Payers
- Strong communication skills
Work Shift Timing: US Shift timings (Evening 7:30 PM to 4:30 AM IST)
Benefits
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 Days
- Flexible Work Environment (Remote/Hybrid Options)
- Peer-based incentive Cheer awards
- All in to Win bonus Program
- Tuition Reimbursement Program
To 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.
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