Credentialing Manager
Finni Health (YC W23)
RCM Account Manager
Assembly Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Serve as the primary point of contact for assigned Nextech clients, addressing inquiries and concerns proactively and building/maintaining strong relationships with healthcare providers and stakeholders.
- Conduct regular client meetings to review RCM performance, discuss challenges, and align on financial goals; provide ongoing education to clients on RCM processes, industry trends, and regulatory changes.
- Monitor and analyze KPIs such as Days Sales Outstanding (DSO), Denial Rates, AR Aging, and Net Collections; identify trends and implement solutions to optimize revenue collection and minimize delays.
- Collaborate with internal billing, coding, and collections teams to ensure timely claims submission, payment posting, and follow-ups; address payer issues, reimbursement challenges, and operational bottlenecks.
- Develop and execute action plans to improve financial outcomes for clients; ensure compliance with industry regulations (HIPAA, CMS, payer policies) and best practices.
- Provide detailed reporting and insights on revenue cycle health; partner with leadership to refine workflows and enhance efficiency.
- Investigate and resolve client issues related to claims, payments, or system inefficiencies; work cross-functionally with internal teams to drive process improvements and identify automation/technology enhancements.
Requirements
- 5+ years in revenue cycle management, medical billing, or healthcare account management.
- Bachelor’s degree in healthcare administration, Business, or equivalent years of professional experience.
- Experience with Nextech EMR Software, payer portals, and reporting tools; other RCM software experience preferred (e.g., Nextgen, Athena, eClinicalWorks).
- Strong understanding of medical billing, coding (CPT, ICD-10), insurance verification, and reimbursement processes.
- Knowledge and familiarity with ProFee coding for ambulatory care practices.
- Excellent communication, problem-solving, and customer service skills.
- Experience with financial reports, data analysis, and KPI tracking.
- 3+ years’ experience in supervising staff and overseeing workflow functions.
- Ability to function well in a fast-paced and at times stressful environment.
- Prolonged periods of sitting at a desk and working at a computer; ability to lift and carry items up to 10 pounds.
