RCM Integration Director

Company: Elevateent
Location: Miami
Posted on: November 17, 2024

Job Description:

At Elevate ENT Partners, our commitment lies in delivering exceptional patient care while prioritizing the satisfaction of our team members. We strive to attract and retain the industry's finest talent-individuals who are passionate about their roles and driven to effect meaningful change in a dynamic healthcare landscape. Explore our career opportunities below and become part of our dedicated team!An Equal Opportunity Employer and Drug Free WorkplaceAs the Director of RCM Integrations, you will play a key role in optimizing and integrating revenue cycle management processes for recently acquired practices. You will manage the RCM function for new practices: some will require long-term management under legacy EMR while others will be integrated quickly into the Elevate eClinicalWorks Enterprise Environment. You will also be responsible for overseeing clearinghouses and third-party vendors to streamline financial workflows, increase reimbursement rates, and improve overall practice efficiency of new acquisitions. This role requires a deep understanding of RCM processes, excellent technical skills, and a proactive approach to problem-solving.Essential Job Functions

• Integration Management:
  • Serve as the primary point of contact for the integration of new acquisitions with RCM software, billing systems, and third-party vendors.
  • Lead and oversee the successful configuration, implementation, and integration of RCM functionalities within eClinicalWorks.
  • Work closely with IT teams and external vendors to ensure the secure and accurate transfer of data between systems.
  • Troubleshoot integration issues, escalate problems when necessary, and work toward timely resolution.
  • Revenue Cycle Optimization:
    • Identify areas for improvement within the RCM workflow and recommend optimizations to maximize revenue capture.
    • Ensure that EMRs are used to their full capacity in terms of billing, coding, claims management, and payment posting.
    • Stay updated on regulatory changes, coding updates (e.g., ICD-10, CPT), and payer requirements that may impact RCM processes.
    • Training and Support:
      • Oversee training and technical support to billing and front-office staff on eClinicalWorks functionalities.
      • Educate staff on best practices for revenue cycle management, claim submission, and denial management within eClinicalWorks.
      • Reporting and Analytics:
        • Generate regular and ad-hoc reports to analyze financial performance, including claims status, accounts receivable, and revenue trends.
        • Assist in developing dashboards and KPIs to monitor practice performance and identify areas needing improvement.
        • Compliance and Documentation:
          • Ensure adherence to HIPAA and other compliance regulations when managing patient information and financial data.
          • Maintain thorough documentation of integration setups, workflows, and any customizations applied to eClinicalWorks and other EMRs (e.g., ModMed).
          • Monitor system updates and changes in payer rules to keep the RCM process compliant.Supervisory ResponsibilityIntegration specialists, local practices RCM manager/supervisorsWork Environment and Physical DemandsHybrid work environmentTravelAs NeededRequired Education and Experience
            • Bachelor's degree in healthcare administration, information technology, or a related field (preferred).
            • Certifications in RCM, medical coding, or billing (e.g., CPC, CRCR) are a plus.
            • 7+ years of experience in revenue cycle management, preferably within a healthcare setting.
            • At least 2 years of hands-on experience with eClinicalWorks in an RCM role.
            • Proven experience with integration and implementation of healthcare systems (especially EMRs and billing software).Technical Skills
              • Strong proficiency in eClinicalWorks, including EHR and PM functionalities.
              • Familiarity with medical billing, coding (ICD-10, CPT), claim submission, and denial management workflows.
              • Experience with API integrations, clearinghouses, and third-party systems relevant to RCM.
              • Experience with ModMed and Athena EMRs a plus.
              • Proficiency in Excel, SQL, or other data analysis tools.
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