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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing accounts receivable processes, including handling complex payer denials and ensuring compliance with policies and procedures. Proficient in utilizing billing systems and payer websites to achieve RCM KPIs and support client services.
Highest-signal resume keywords
Accounts Receivable ManagementAllscripts PM ExperienceKnowledge of CPT, ICD-10, and ModifiersExperience with Billing SystemsPayer Website Utilization
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Accounts Receivable ManagementBilling Systems ExperienceKnowledge of CPTKnowledge of ICD-10Payer Denial HandlingClaims ProcessingData ReconciliationMedical Insurance Claims ResearchError-Free Transaction ManagementRCM KPI Achievement
Soft Skills
Effective CommunicationClient InteractionProblem-SolvingTraining and Mentoring
Tools & Technologies
AllscriptsLaserficheMicrosoft ProductsMS AccessPowerPointCrystal ReportsNextGenEpicSharePoint
Industry Keywords
Medical BillingHealthcare Revenue Cycle ManagementHMOsIPAsMedicare Fee for Service PlansCommercial PayersPsychiatryInternal MedicineOrthopedicsGeneral Surgery
About the role
Key responsibilities & impact- Manage and recover accounts receivable for RCMS clients
- Research and follow up on medical insurance claims
- Prepare appeals and responses to insurance carriers
- Support Operations and Client Services by driving the accounts receivable process and achieving RCM KPIs
- Answer client, patient, and carrier calls and respond promptly to information requests
- Manage unpaid claims using office management/administrator systems, aging reports, correspondence, clearinghouse and PM rejections, and SharePoint
- Handle complex payer denials
- Ensure secondary claims are processed and paid
- Monitor and reconcile held vouchers, unbilled vouchers, denial trends, patient balance reports, credits, and refunds
- Manage and track information requests to clients
- Comply with and enforce policies and procedures
- Achieve RCM management goals for error-free work, transactions, processes, productivity, and compliance, including working 1,400 accounts per month
- May support new hires as a training partner
- Perform other duties as assigned
Requirements
What you’ll need- 1+ year relevant work experience
- Prior experience on Allscripts PM preferred
- Extensive knowledge of email, search engines, and the Internet
- Ability to effectively use payer websites and Laserfiche
- Basic competence in Microsoft products
- Preferred experience with MS Access and PowerPoint
- Preferred experience with Crystal Reports
- Experience with billing systems such as NextGen, Pro, Allscripts, and Epic
- Knowledge of CPT, ICD-10, and modifiers
- Experience in specialties such as Psychiatry, Internal Medicine, Orthopedics, and General Surgery
- Familiarity with HMOs and IPAs, Medicare Fee for Service Plans, and Commercial Payers
- May require after-hours, on-call support, and/or holiday work
- Must be legally authorized to work in the United States or Canada
- Visa sponsorship is not offered
Benefits
Comp & perks- Comprehensive compensation and benefits package
- Holidays
- Vacation
- Medical insurance
- Dental insurance
- Vision insurance
- Company-paid life insurance
- Retirement savings
- Flexible work arrangements, including remote work
- Professional development support