Full-Time

RCM Operations Support Specialist

Worker's Comp

Posted on 6/27/2024

Modernizing Medicine

Modernizing Medicine

1,001-5,000 employees

Specialty-specific electronic health record systems

Biotechnology
Healthcare

Junior, Mid

Remote in USA

Category
Customer Success
Customer Support
Customer Success & Support
Required Skills
Communications
Requirements
  • Bachelor's degree preferred; Medical Billing and Coding certification preferred.
  • Two plus years of related experience and/or training or equivalent combination of education and experience.
  • Extensive knowledge of Workers’ Compensation payers including state nuances, laws, reports, payment rules and solutions for quick claim adjudications.
  • Exceptional written, verbal and interpersonal communication skills required.
  • Highly detail oriented with a critical degree of accuracy.
  • Intermediate Excel skills such as the ability to use formulas to analyze data, create and formatting pivot tables and templates, use of conditional formatting and validation functions. Able to create visualizations of data through charts and graphs.
  • Mastery of spreadsheets including the ability to manage information located in multiple software systems.
  • Expertise in medical billing, front-office, physician practice management and healthcare business processes.
  • Self-motivated; takes initiative and approaches problem solving with creativity and excitement.
  • Develop expert knowledge and workflows in respective ModMed products (PM and/or gPM) within 5 months of employment.
  • Strong understanding of various insurance carriers, including Medicare, private HMOs, and PPOs.
  • Team player with a positive attitude, adaptable when faced with change.
  • Professional demeanor required.
  • Able to travel (up to 10%).
Responsibilities
  • Supports overall medical billing operations and timely processing of claims, including:
  • Being a Subject Matter Expert on Worker’s Compensation and Auto/PIP workflows.
  • Provide knowledge and support to other RCM team members to facilitate resolving claim inquiries related to billing and Worker’s Compensation and Auto/PIP workflows.
  • Reviewing and resolving Patient inquiries.
  • Conducting comprehensive performance audits of client practices to support best practices and optimal workflow for all parties. This includes:
  • Monitor billing activity
  • Assessing KPI metrics
  • Monitor payment posting activity
  • Payer and coding trend analysis
  • Meet and communicate with Client Success, RCM Coordinator and Global Partners to share best practice and recommend workflow changes
  • Specialty specific RCM support including:
  • Monitor and support production team activity
  • Identify and develop specialty specific best practices to help streamline RCM processes
  • Participate in team meetings
  • Payer and coding trend analysis
  • Facilitate communication between Client Success, RCM Coordinator and Global Partners
  • Developing strong relationships with adjusters and/or payers.
  • Collaborating on Standard Operating Procedures (SOP) to include specific workflows and needs to ensure smooth revenue cycle.
  • Collaborates with multiple BOOST departments in resolving client escalations.
  • Performing additional projects and job duties as assigned.

Modernizing Medicine provides specialty-specific Electronic Health Records (EHR) systems designed to improve the workflow of healthcare providers. Their main products, EMA and gGastro EHR, help users manage patient information and administrative tasks more efficiently, allowing them to concentrate on patient care. These systems adapt to the specific practices of each user, enhancing their effectiveness. Unlike many competitors, Modernizing Medicine focuses on tailored solutions for various medical specialties, which sets them apart in the healthcare technology market. The company's goal is to streamline healthcare delivery and improve patient outcomes by providing tools that simplify administrative processes.

Company Stage

Late Stage VC

Total Funding

$360.6M

Headquarters

Boca Raton, Florida

Founded

2010

Growth & Insights
Headcount

6 month growth

0%

1 year growth

-1%

2 year growth

3%
Simplify Jobs

Simplify's Take

What believers are saying

  • ModMed consistently ranks #1 in G2's 2024 Grid Reports for EHR and RCM software.
  • Collaboration with Brevium enhances patient re-engagement, boosting retention in gastroenterology practices.
  • Appointment of Dan Costantino as CISO strengthens cybersecurity, crucial for healthcare data protection.

What critics are saying

  • Potential sale by Warburg Pincus could lead to strategic shifts misaligned with current goals.
  • Resistance to AI technologies may slow implementation and affect user satisfaction.
  • Dependency on Medtronic's technology poses risks if partnership faces challenges or strategic changes.

What makes Modernizing Medicine unique

  • ModMed offers specialty-specific EHR systems, enhancing workflow efficiency for healthcare providers.
  • Their EHR systems, EMA and gGastro, adapt to user practices, increasing adaptability.
  • ModMed integrates AI technologies, like Medtronic's GI Genius, to improve procedural accuracy.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Vacation

Paid Sick Leave

Paid Holidays

Parental Leave

401(k) Retirement Plan

401(k) Company Match

Professional Development Budget

Conference Attendance Budget

Hybrid Work Options

Remote Work Options

Wellness Program

INACTIVE