ModMed is hiring a Enterprise RCM Client Advisor to join our positive, passionate, and high-performing Revenue Cycle Management team who is responsible for managing and communicating the revenue cycle activities and performance, as well as playing a pivotal role in facilitating client growth, workflow development, and executive communication. This is an exciting opportunity to understand the business needs of enterprise customers and anticipate reporting and performance needs that would best serve the client's business goals within a fast-paced Healthcare IT company that is truly Modernizing Medicine!

Your Role:

• Manage overall medical billing operations, including:

  • Provide a high-level of value and customer service to both our enterprise client practices by identifying and efficiently working with BOOST operations and the client to resolve insurance and other billing-related issues
  • Establish, implement and manage Practice Performance Plans that identify, quantify and resolve issues that are impacting service levels and/or delivery of contractual obligations, as needed
  • Conduct routine client meetings to review business metrics, progress, and other proactive topics to ensure high quality delivery of contracted services
  • Coordinate internal resources to facilitate optimal service delivery as needed
  • Collaborate with operational functions on aggressive strategies to facilitate positive client outcomes related to revenue cycle
  • Monitor, assist and advise enterprise client on optimal administrative settings, related to fee schedules, payer settings and workflow opportunities
  • Identify and implement strategies to improve internal and customer processes
  • Proactively seek and identify revenue growth opportunities for the client

• Leverage deep knowledge and understanding of clients' key practice revenue performance metrics to drive SLA achievements, consult and advise our clients on a weekly basis. Revenue cycle performance metrics include:

  • Denials and rejection
  • Net Collection Ratio
  • Charge, adjustment and payments analysis
  • Accounts receivable

• Review and analyze customer accounts; identify trends and issues, recommend and implement solutions and see through to a successful resolution:

  • Denials trend management
  • Office workflow efficiency opportunities
  • Payer-related trend analysis and education related to policies and procedures for payers
  • Payer online portal & gaining access
  • ERA Enrollments

• Ensure Client Key Performance Indicator benchmarks are met:

  • Days Sales Outstanding (DSO): 35 days and under
  • Insurance aging over 90 days: less than 15%
  • Denials: less than 5%
  • Escalated clients based on metrics: less than 10% (enterprise-wide)
  • Client referenceability is 35% or higher (enterprise-wide)
• Maintain knowledge on current healthcare industry and specialty related changes.
• Keep abreast with ModMed software enhancements and releases.
• Collaborate with internal and global services team members to improve overall client metrics.
• Promote collaborative relationships with operational leadership and on and offshore partners.
• Participate in sales calls as needed to demonstrate depth of domain expertise.
• Advanced reporting, project initiation, and management with a focus on a proactive reduction of upstream challenges faced by large organizations.
• Perform additional projects and job duties as assigned.
• Subject matter expert on processes and workflows related to RCM Advisor role.

Skills & Requirements:

• Bachelor's Degree preferred
• Medical billing and coding certification preferred
• 3 years of related experience and/or training or equivalent combination of education and experience; Ophthalmology experience highly preferred
• Strong analytical and problem solving skills required
• Exceptional written, verbal and interpersonal communication skills required
• Excellent client-facing and presentation skills
• Extensive knowledge of medical billing/coding, front-office, physician practice management and healthcare business processes
• Advanced Excel skills such as the ability to use formulas to analyze data, create tables and pivot tables, formatting and conditional formatting
• Ability to manage and integrate information located in multiple software systems
• Strong understanding of various insurance carriers, including Medicare, private HMOs, and PPOs
• Professional demeanor required

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