RCM Team Lead

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 doctor's 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/