RCM Operations Analyst

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• South Florida Business Journal, Best Places to Work 2024
• Inc. 5000 Fastest-Growing Private Companies in America 2023
• Company of the Year | 2023 BIG Innovation Awards
• Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards

Who we are:

We Are Modernizing Medicine (WAMM)! We’re a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed is based in Boca Raton, FL, with office locations in Santiago, Chile, Berlin, Germany, Hyderabad, India, and a robust remote workforce with team members across the US.

ModMed is hiring a driven RCM Operations Analyst to join our positive, passionate, and high-performing RCM team. The RCM Operations Analyst assists our RCM Client Success team by monitoring our client financial data and performance metrics to contribute to performance improvement and client satisfaction. The RCM Operations Analyst supports our RCM Client Success team in analyzing charges, payments, encounters, A/R, and denials data for our clients to decrease the percentage of denials, improve collections on claims, and identify practice trends.

In addition, The RCM Operations Analyst is responsible for developing tools and methodologies to monitor, analyze, and forecast revenue cycle trends. Ongoing responsibilities include collaborating with data management consultants, Client Success stakeholders, and operations leadership, researching client performance trends/issues, and providing forensic insight into data requests. This is an exciting opportunity to improve medical practices' financial health within a fast-paced Healthcare IT company that is truly Modernizing Medicine!

Your Role:

• Identify opportunities to improve revenue and collection performance through analysis of charges, claim denials, payments, accounts receivable, and escalated client metrics
• Monitor operational key performance indicators to identify the root cause of poor-performing metrics and make recommendations for improvement
• Serve as a subject matter expert for proprietary software, PM, gPM, and necessary analytic tools such as Qlik Sense, Salesforce, TPS, & NHXS
• Develop strategies to capture additional data for better insight into performance improvement opportunities
• Assist management in developing meaningful reports and summaries that provide support to the RCM Client Success team
• Leverage management reports identifying areas for operational improvements and efficiencies for clients throughout their RCM lifecycle
• Generate standard and custom statistical and analytical reports as requested by RCM Leadership using the Patient Accounting Systems, Microsoft Excel, SQL, and/or Qlik
• Extract datasets from PM, Qlik, and other applications as necessary
• Completion of Ad Hoc report request as assigned by management
• Conduct detailed research into data and performance changes as identified and requested
• Perform initial and final quality control assessment of reports prior to distribution
• Serve as an RCM Client Success point of contact for new report requests/modifications
• Collaborate with the technology teams and consultants on the design of internal databases and data needs
• Complete accuracy checks of existing reports
• Provide support to the Client Success and Operational teams in analyzing our clients’ data
• Facilitate internal Client Success Denial Workgroup
• Establish complementary and collaborative relationships with appropriate stakeholders/committee members, and RCM Leadership
• Identify and develop new client reporting, trending, and performance feedback with benchmarking of success indicators
• Perform other duties as assigned

Skills & Requirements:

• Bachelor’s degree preferred, or equivalent experience in healthcare RCM analytics.
• Certification in Lean Six Sigma Green Belt and Revenue Cycle Professional (CRCP) is required within 6 months of start date.
• 3+ years of experience in analytical role specializing in Revenue Cycle Management, encompassing claims processing, root cause analysis, and deep knowledge in medical insurance policies, and coding guidelines (ICD-10 and CPT). Familiarity with Fee For Service, Capitation, and Workers Compensation
• Expertise in medical billing, physician practice management, and healthcare business processes
• Proficiency in database concepts, data maintenance, and troubleshooting
• Working knowledge of Business Intelligence reporting software preferred
• Advanced Excel skills, including data analysis and reporting
• Strong analytical skills with the ability to analyze organizational financial and operational data
• Excellent communication, interpersonal, and organizational skills, fostering collaboration and communication within teams

#LI-SF1 #LI-REMOTE

ModMed Benefits Highlight:

At ModMed, we believe it’s important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits, including:

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,
• 401(k) Plan with immediate vesting in the company matching contribution,
• Generous Paid Time Off and Paid Parental Leave programs,
• Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability,
• Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.