At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance. In operations and solutions at PwC, you will focus on providing consulting services to optimise overall operational performance and develop innovative solutions. You will work closely with clients to analyse operational processes, identify areas for improvement, and develop strategies to enhance productivity, quality, and efficiency. Working in this area, you will provide guidance on implementing technology solutions, process automation, and operational excellence frameworks.Driven by curiosity, you are a reliable, contributing member of a team. In our fast-paced environment, you are expected to adapt to working with a variety of clients and team members, each presenting varying challenges and scope. Every experience is an opportunity to learn and grow. You are expected to take ownership and consistently deliver quality work that drives value for our clients and success as a team. As you navigate through the Firm, you build a brand for yourself, opening doors to more opportunities.
Skills
Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:
- Apply a learning mindset and take ownership for your own development.
- Appreciate diverse perspectives, needs, and feelings of others.
- Adopt habits to sustain high performance and develop your potential.
- Actively listen, ask questions to check understanding, and clearly express ideas.
- Seek, reflect, act on, and give feedback.
- Gather information from a range of sources to analyse facts and discern patterns.
- Commit to understanding how the business works and building commercial awareness.
- Learn and apply professional and technical standards (e.g. refer to specific PwC tax and audit guidance), uphold the Firm's code of conduct and independence requirements.
JD Template -Corp Managed Svcs RCMS - Associate - Operate
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Job Summary -
A career in our Managed Services team will give you an opportunity to collaborate with many teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology. Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients' revenue cycle functions. We specialize in front, middle and back-office revenue cycle functions for hospitals, medical groups, and other providers. We leverage our custom and automated workflow and quality assurance products to enable our clientsto achieve better results, which ultimately allows them to provide better patient care.
Minimum Degree Required (BQ) *:
Bachelor’s Degree
Degree Preferred
Bachelor’s Degree
Required Field(s) Of Study (BQ)
Computer Science, Data Analytics, Accounting
Preferred Field(s) Of Study
Minimum Year(s) of Experience (BQ) *:
US
1 year of experience
Certification(s) Preferred
Required Knowledge/Skills (BQ):
- Preferred Qualification: Bachelor’s degree in finance or Any Graduate
- 2-4 years of progressive experience in healthcare revenue cycle management, with a focus on accounts receivable and claims resolution.
- Strong knowledge of medical billing processes, insurance reimbursement methodologies, and revenue cycle operations.
- Experience with healthcare billing software (e.g., Epic, Cerner, Meditech) and proficiency in Microsoft Office applications.
- Excellent leadership, communication, and interpersonal skills with the ability to mentor and motivate team members.
- Analytical mindset with the ability to interpret financial data, identify trends, and make data-driven decisions.
- Proven track record of achieving AR performance targets and improving revenue cycle efficiency.
- Experience Level: 2 to 4 years
- Shift timings: Flexible to work in night shifts (US Time zone)
Preferred Knowledge/Skills *:
Accounts Receivable Management
- Oversee the accounts receivable process, including insurance and patient follow-up, to minimize outstanding balances.
- Monitor and analyze aging reports to prioritize and address delinquent accounts promptly.
- Implement strategies to improve collections and reduce accounts receivable days.
Insurance And Payer Relations
- Lead efforts in resolving complex insurance claim issues, including claim denials and underpayments.
- Establish and maintain relationships with insurance company representatives to facilitate prompt payment and claims processing.
- Stay updated on insurance policies, reimbursement regulations, and industry trends affecting revenue cycle operations.
Patient Communication And Customer Service
- Assist with escalated patient inquiries and complaints related to billing and insurance matters.
- Educate patients on insurance benefits, coverage details, and financial responsibilities.
- Collaborate with patient advocacy groups and financial counselors to ensure compassionate and effective patient interactions.
Process Improvement And Training
- Identify opportunities for process improvements within the revenue cycle management workflow.
- Develop training materials and conduct sessions to enhance the skills and knowledge of AR team members.
- Implement best practices to streamline AR operations and maximize efficiency.
Reporting And Analysis
- Generate and present regular reports on accounts receivable performance metrics, trends, and outcomes.
- Utilize data analytics to identify root causes of revenue cycle issues and implement corrective actions.
PMS Experience
- Epic HB & PB experience is Mandatory
Compliance And Regulatory Adherence
- Ensure compliance with HIPAA regulations, billing guidelines, and healthcare industry standards.
- Collaborate with compliance officers to implement and maintain effective internal controls.
