NextGen RCM Specialist

Responsibilities

Work collaboratively with peers, offshore vendors, and senior management to ensure business needs are met.

Provide support to physicians and care center staff with RCM questions or escalations.

Conduct account research and analysis.

Understand Payer nuances and will be able to help in creating payer-specific billing rules.

Identify and execute necessary process initiatives related to Billing, adjustments, etc.

Prepare and maintain various reports.

Interact with internal and external customers to resolve outstanding issues.

Maintain confidentiality of all information; adhere to all HIPAA guidelines/regulations.

Additional duties to be assigned from time to time.

Required Experience and Skills

Minimum 3 years experience with NextGen EPM software - Preferred

Minimum of progressive professional experience in healthcare revenue cycle management.

Proficient in government and commercial insurance billing and experience with working on various Clearing houses (Waystar, Trizetto, etc)

Proficient in the use of Excel, Word, and PowerPoint or equivalent Google software

Knowledge and understanding of ICD-10, CPT, and HCPCS codes and payer-specific coding guidelines.

Knowledge and understanding of medical terminology and procedures.

Knowledge of coding, medical records, remittance codes, and reimbursement policies

Experience working on HL7 library - Not Mandatory

High School diploma or general equivalency.

Good verbal and written communication skills.

Ability and willingness to work flexible hours to meet staffing needs.

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