Team Leader – RCM (DMEPOS)

We are pioneers in revolutionizing healthcare with our advanced technology solutions. We are dedicated to enhancing operational efficiency, improving patient care, and driving superior health outcomes across the healthcare sector. As we expand, we are looking for a dedicated Team Leader – RCM to lead our Revenue Cycle Management team, ensuring excellence in our billing and insurance follow-up processes.

Experience: 7-8 years(2 years in DMEPOS)

Shift : Night/US

What You’ll Do

As a Team Leader – RCM at SolvEdge, you will oversee and guide a team of professionals in Revenue Cycle Management, ensuring high-quality performance and operational efficiency. Your role is crucial in setting goals, monitoring team performance, and implementing strategies that enhance revenue and client satisfaction.

Your primary duties include:

• Team Management: Set team goals and KPIs. Delegate tasks, manage day-to-day operations, and oversee performance. Create a motivating work environment and conduct regular evaluations.
• Client Communication: Update clients on project performance, address concerns, and ensure SLAs are met. Join client calls as needed.
• Performance Oversight: Ensure high-quality delivery and process efficiency. Analyze trends in charges, coding, and collections. Address issues proactively and implement strategies for improvement.
• Reporting: Prepare and review AR reports and financial reports. Monitor and report on team performance and project outcomes.
• Training and Development: Identify training needs, provide coaching, and organize team-building activities. Resolve team conflicts and integrate feedback.
• Operational Efficiency: Manage work allocation and workforce effectiveness. Stay updated with carrier rule changes and share information with clients and the team.
• Financial Management: Oversee month-end financial closeout, provide billing information for RCM revenues, and maintain SOPs based on client feedback.
• Strategic Planning: Adjust staff and policies based on performance metrics. Develop strategies to enhance revenue and meet client goals.

Requirements:

• Experience: 7 – 8 years in insurance follow-up and team handling, with at least 2 years in DMEPOS.
• Skills: Excellent written and verbal communication skills. Proficiency in end-to-end billing processes and multiple billing software.
• Billing Knowledge: Strong knowledge of end-to-end billing processes, including CPT and ICD-10 Codes, HCFA 1500, and UB04 Claim forms. Familiarity with insurance guidelines, HIPAA, and appeal processes.
• Software Proficiency: Experience with at least three billing software systems, such as Nymbl, OPIE, ECW, Advance MD, Athena, Office Ally, MedEvolve, Allscripts, and Cerner.
• Analytical Skills: Ability to perform trend analysis and strategic planning for revenue improvement. In-depth knowledge of performance metrics.
• Leadership Experience: Strong people management skills with experience handling large teams (15+ FTE) across various RCM verticals such as Insurance Eligibility and Verification, Patient Demographic, Charge Entry, Claim submission and fixing rejections, Payment Posting, A/R Follow-up, Denial management, correspondence and patient A/R..
• Industry Knowledge: Experience in specific areas such as prosthetics, orthotics, orthopedics, pain management, chiropractic, radiology, sports medicine, physical therapy, and family practice.
• Operational Management: Proven track record in managing daily operations, including production, quality, and error tracking. Ability to handle multiple projects concurrently.
• Strategic Abilities: Skilled in developing strategies, creating dashboards, and applying new concepts to improve efficiency and meet client goals.
• Work Ethic: Sense of ownership and pride in performance with a willingness to work continuously in night shifts.
• Problem-Solving Skills: Critical thinker with strong problem-solving abilities.

Why Apply?

Even if you feel you don’t meet every single requirement, we encourage you to apply. We value passion, expertise, and a commitment to excellence. At SolvEdge, we are committed to fostering growth and opportunity within our organization.

How to Apply?

Ready to lead and make an impact? Submit your resume, a cover letter highlighting your qualifications, and also your work experience with role played in previous organization. We look forward to hearing from you!

SolvEdge is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

About SolvEdge

Solvedge: Pioneering the Future of Digital Healthcare

Our Expertise

SOLVEDGE stands at the forefront of digital healthcare innovation as a premier healthcare performance company. With over 18 years of dedicated service in the healthcare industry, we specialize in a digital care journey platform that revolutionizes how hospitals and health systems engage, monitor, and connect with patients throughout their healthcare experiences. Our partnership with Fortune 100 medical device companies and hospitals nationwide underscores our position as a trusted partner in healthcare solutions.

Key Features of SOLVEDGE

Our platform is designed to empower healthcare providers with the tools they need to automate and streamline care delivery, thereby improving clinical outcomes and patient satisfaction:

• Personalized Care Plans: Leveraging evidence-based data, SOLVEDGE delivers digital care plans customized to meet the individual needs and conditions of each patient.
• Real-Time Patient Monitoring: Through daily health checks, assessment, surveys, and integration with wearable devices, our platform facilitates continuous monitoring of patient health.
• Automated Care Delivery: We automate essential tasks, including appointment scheduling, sending reminders, and delivering educational content, to enhance patient engagement and reduce administrative tasks.
• Remote Patient Monitoring: Healthcare providers can monitor vital signs, symptoms, and treatment plan adherence remotely, enabling timely interventions and proactive care management.

The SOLVEDGE Advantage

Our platform offers significant benefits to healthcare providers and patients alike:

• Improved Clinical Outcomes: By facilitating more effective care pathways and enabling early intervention, SOLVEDGE contributes to reduced readmission rates, fewer emergency department visits, and shorter hospital stays.
• Enhanced Patient Satisfaction: Patients enjoy a higher quality of care with SOLVEDGE, benefiting from improved communication, comprehensive education, and continuous support.
• Cost Savings: Healthcare organizations can achieve substantial cost reductions by minimizing unnecessary readmission, emergency visits, and complications associated with poor care management.

Applications and Impact: SOLVEDGE’s versatility allows for its application across various aspects of healthcare, with a particular emphasis on surgical care. From preparing patients for surgery to monitoring their post-operative recovery, our platform ensures a seamless and supportive care journey. Beyond surgical care, our focus encompasses managing care pathways, enhancing patient engagement through patient-reported outcomes, providing advanced data analytic, integrating with electronic medical records (EMR), and streamlining billing processes. Our comprehensive approach addresses the myriad challenges faced by today’s healthcare industry, backed by our commitment to excellence in service, communication, and customer experience.

A Trusted Partner in Healthcare Innovation: Our strategic relationships and deep understanding of healthcare challenges have positioned us as an indispensable ally to healthcare providers nationwide. As we continue to develop innovative solutions, our goal remains unchanged: to simplify healthcare delivery, improve patient outcomes, and enhance the overall patient experience.

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