Abrar Admin

HealthRev Partners

<div>Job Summary: 
The RCM Specialist for Home Health &amp; Hospice plays a crucial role in ensuring the efficient and accurate processing of claims and patient accounts, contributing to the organization's financial health. They possess a comprehensive understanding of revenue cycle processes and demonstrate expertise in resolving complex claims and patient billing issues. 


Essential Duties and Responsibilities:
<ul>
<li>Lead and optimize the full revenue cycle process from billing the claim to final payment collection.</li>
<li>Collaborate with the RCM team to maintain a clean and compliant revenue cycle.</li>
<li>Generate claims accurately from EMR system to clearinghouse and monitor the claim following HRP standard protocol.</li>
<li>Resubmit claims corrected as needed and communicate issues that need to be resolved.</li>
<li>Communicate unbilled and billed claim holds to Team Leader or RCM Manager.</li>
<li>Analyze and resolve complex claims denials and appeals.</li>
<li>Investigate and address patient billing discrepancies and disputes.</li>
<li>Identify and implement strategies to improve revenue cycle performance as needed.</li>
<li>Collaborate with cross-functional teams to implement and manage assigned RCM accounts.</li>
<li>Participate in revenue cycle audits and compliance reviews (quality review checks).</li>
<li>Develop and maintain accurate and up-to-date documentation of all claims and patient accounts.</li>
<li>Provide training and support to other RCM team members.</li></ul> 


Key Performance Indicators (KPIs):
<ul>
<li>Clean claim rate &gt;95%</li>
<li>Aged AR &lt; 20% of total AR</li>
<li>Meets productivity expectation of 45 non-Medicare claims per day or 75 Medicare</li>
<li>Net collection rate of &gt;95%</li>
<li>Meets and passes 100% of quality review checks completed by RCM Manager</li></ul> 


Qualifications:
<ul>
<li>3&ndash;5 years of experience in revenue cycle management in the home health and hospice realm</li>
<li>Proficient in Microsoft Office Suite 365</li>
<li>Proficient in home health and hospice electronic health records (EHR) systems</li>
<li>Strong understanding of insurance billing and coding procedures</li>
<li>Excellent communication, problem-solving, and analytical skills</li>
<li>Ability to work independently and as part of a team</li>
<li>Proven track record of success in resolving complex claims and patient billing issues</li></ul> 


Benefits:
<ul>
<li>Competitive salary and comprehensive benefits package, including health insurance, dental insurance, vision insurance, paid time off, and 401k savings plan</li>
<li>Opportunity to work in a dynamic and growing healthcare organization</li>
<li>Professional development and training opportunities</li>
<li>Contribution to the organization's financial success and patient satisfaction</li></ul></div>

RCM Specialist- Home Health and Hospice

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HealthRev Partners

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RCM Specialist- Home Health and Hospice