NextGen RCM Specialist

Job Title

Essential Duties and Responsibilities:

• Work collaboratively with peers, offshore vendors, and senior management to ensure business needs are met.
• Provide support to physicians and care center staff with RCM questions or escalations.
• Conduct account research and analysis.
• Understand Payer nuances and will be able to help in creating payer-specific billing rules.
• Identify and execute necessary process initiatives related to Billing, adjustments, etc.
• Prepare and maintain various reports.
• Interact with internal and external customers to resolve outstanding issues.
• Maintain confidentiality of all information; adhere to all HIPAA guidelines/regulations.
• Additional duties to be assigned from time to time.

Required Experience and Skills:

• Minimum 3 years experience with NextGen EPM software - Preferred
• Minimum 3 years of progressive professional experience in healthcare revenue cycle management.
• Proficient in government and commercial insurance billing and experience with working on various Clearing houses (Waystar, Trizetto, etc)
• Proficient in the use of Excel, Word, and PowerPoint or equivalent Google software
• Knowledge and understanding of ICD-10, CPT, and HCPCS codes and payer-specific coding guidelines.
• Knowledge and understanding of medical terminology and procedures.
• Knowledge of coding, medical records, remittance codes, and reimbursement policies
• Experience working on HL7 library - Not Mandatory
• High School diploma or general equivalency.
• Good verbal and written communication skills.
• Ability and willingness to work flexible hours to meet staffing needs.