What are the responsibilities and job description for the NextGen RCM Specialist position at Texas Health Care PLCC?
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.