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R1 RCM
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Senior Program Manager

Senior Program Manager

R1 RCM

1 - 3 years

13 - 18 Lacs

gurugram

Posted:1 hour ago| Platform:

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Skills Required

us healthcare program management mis drg rcm hipaa ip drg icd ccs cpc medical billing drm ed pcs project management cpt ip patient care root cause analysis hcpcs estimation medical coding icd-10-cm revenue cycle management statistics

Work Mode

Work from Office

Job Type

Full Time

Job Description

About the role:

Needs to work closely and communicate effectively with internal and external stakeholders in an ever-changing, rapid growth environment with tight deadlines. This role involves designing and analyzing the healthcare reimbursement model. Be able take up new initiatives, maintain synchrony in the team. Collaborate with external & internal stakeholders, work effectively in a growing team, be a strong team player. Be able to create and define SOPs,TATs for ongoing and upcoming projects.

What you will do:

To design, analyze and maintain healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts.

To perform various analytical reviews and deep-dives (root cause analysis) on client-specific healthcare reimbursement methodologyto ensure accuracy of revenue projections and actual collections.

To report/highlight the exceptions in reimbursement method by building contract models for Hospital charges

To effectively communicate the findings/ observations with recommended action to US team/clients.

Maintain MIS related to analysis, Accuracy and coverage report for maintenance databases

Handling client calls and communicating effectively for task deliverables and site maintenance

What will you need:

Graduate degree Preferably in Statistics\Mathematics\Economics\Commerce\Finance from a reputed educational institute

Good analytical and algorithm building skills, having experience to build contract models for hospital charges to calculate expected reimbursement

Skills to read, understand and interpret reimbursement contracts between hospitals and insurance providers.

Experience/knowledge of various US healthcare reimbursement methods like MS DRG weightage, Multipliers, % of charges, outliers, Grouper fee schedule etc.

Good Communication Skills (both written & verbal)

Preferable - 1-3 years of experience in US healthcare

Having good knowledge about RCM cycle and denial management

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R1 RCM

Healthcare Revenue Cycle Management

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Senior Program Manager