RCM Functional Lead

A client of Innova Solutions is immediately hiring for a RCM Functional SME

Position Type: Full-Time Contract (W2)
Role: RCM Functional SME
Duration: 3 Months Contract
Location : New York NY (Remote/Travel)

Must have required skills RCM Automation (Revenue Cycle Management) Backend Patient Financial Services (PFS) Expertise AR Follow-Up & Revenue Recovery Healthcare Revenue Cycle Data & Transaction Knowledge Process Translation Automation & AI Review

Primary Skill Required for the Role:

• Team lead or supervisor-level experience (minimum) in backend PFS: denials AR follow-up underpayment identification payment posting/reconciliation or claims/billing
• Working fluency in CARC/RARC denial codes payer contract and fee schedule terms timely filing and appeal deadlines 835/837 remittance data AR aging and collection probability write-off versus adjustment classification credit balance resolution and refunds and coordination of benefits (COB)
• Understanding of upstream billing and claims concepts that affect backend outcomes: 271 eligibility responses 277CA claim acknowledgments claim holds and edits clearinghouse rejections and how a missed edit upstream turns into a downstream denial

Details:
Partner directly with our engineering team to translate real desk-level workflows into system logic: what a denial specialist checks before deciding to appeal versus write off how an AR rep prioritizes a work queue how an underpayment gets flagged and disputed how self-pay balances get tracked toward payment plan or bad debt
Answer the engineering teams questions about how billing and AR decisions actually get made including payer policies contract terms denial code mappings timely filing rules and escalation thresholds
Help build a reference library (policies templates procedures) the AI can pull from
Write up how you do the job today in a way that can be turned into clear rules and instructions
Review AI-drafted output (appeal drafts dispute packages classification decisions) for accuracy against how a real specialist would handle the account

The ideal candidate will have: 10 years of experience in RCM and AR follow ups and Backend Patient Financial Services (PFS) Expertise.

Qualified candidates should APPLY NOW for immediate consideration!
This position is only open to applicants who can be engaged on a W-2 basis.
Please hit APPLY to provide the required information and we will be back in touch as soon as possible.
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you we do offer a referral bonus program for referrals that we successfully place with our clients subject to program guidelines. ASK ME HOW.
Thank you!

Suraj Yadav

PAY RANGE AND BENEFITS:
Pay Range*: $60 - $65/- Per Hour
*Pay range offered to a successful candidate will be based on several factors including the candidates education work experience work location specific job duties certifications etc.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage Dental/vision insurance 401(k) Health saving account (HSA) and Flexible spending account (FSA) Life Insurance Pet Insurance Short term and Long term Disability Accident & Critical illness coverage Pre-paid legal & ID theft protection Sick time and other types of paid leaves (as required by law) Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta Georgia Innova Solutions employs approximately 50000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America Asia and Europe we deliver strategic technology and business transformation solutions to our clients enabling them to operate as leaders within their fields.

Recent Recognitions:

• Named One of Americas Best Employers for New Grads by Forbes (2024)
• Named One of the Best Companies to Work for by U.S. News & World Report (Private Companies List 2024-2025)
• One of the Largest IT Staffing Firms in the US Ranked #3 by Staffing Industry Analysts (SIA 2024)
• One of the Largest Staffing Firms in the US Ranked #13 by Staffing Industry Analysts (SIA 2024; includes Innova Solutions Volt & HireGenics)
• Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
• One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC 2024)
• AWS Advanced Tier Services Partner with 100 certifications

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Innova Solutions offers a referral bonus for qualified Ambassadors who refer eligible referrals. Submit referrals at and earn $250-$1000 per referral.
Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race color religion or belief national origin citizenship social or ethnic origin sex age physical or mental disability veteran status marital status domestic partner status sexual orientation or any other status protected by the statutes rules and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment please contact us at or . Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status immigration status or national origin in accordance with 8 U.S.C. 1324b.
The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance the Los Angeles Fair Chance Initiative for Hiring Ordinance and other applicable laws.
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