Meduit | Driving Revenue Cycle Performance

Insurance

• Reduce outstanding accounts receivable by managing claims inventory
• Speak to patients and insurance companies in a professional manner regarding their outstanding balances
• Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility, determine financial responsibility and/or to identify sources of payment for services
• Request, input, verify, and modify patient’s demographic, primary care provider, and payor information
• Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
• Answer questions by phone and provide quotes for services; identify financial resources, etc.
• Utilize various databases and specialized computer software for revenue cycle activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts
• Explain charges, answer questions, and communicate a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
• Work with Claims and Collections to assist patients and their families with billing and payment activities

Insurance Specialist – Eastern & Central Time Zones

• Review accounts for credit balances and denials, determine root cause, and take appropriate corrective action (refund, adjustment, rebill, or appeal)
• Review and resolve credit balances across all payers, with priority on regulatory accounts (e.g., Medicare credit balance reporting)
• Submit timely, accurate appeals and process credit resolutions in alignment with payer and regulatory guidelines (including Medicare credit balance requirements)
• Ensure all account activity supports forward movement toward resolution with a one-touch mindset
• Maintain thorough, audit-ready documentation and accurate account notes
• Meet established productivity (APH) and quality standards while prioritizing high-risk, high-dollar, and timely filing accounts
• Collaborate cross-functionally to resolve issues and prevent recurrence
• Identify trends and escalate systemic issues, providing feedback for process improvement
• Initiate and track refunds, adjustments, and reapplications accurately and timely

Insurance Specialist – Credit Resolution

• Reduce outstanding accounts receivable by managing claims inventory
• Speak to patients and insurance companies in a professional manner regarding their outstanding balances
• Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for services
• Request, input, verify, and modify patient’s demographic, primary care provider, and payor information
• Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
• Answer questions by phone and provide quotes for services; identify financial resources, etc. in accordance with client policies and procedures
• Utilize various databases and specialized computer software for revenue cycle activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc.
• Explain charges, answer questions, and communicate a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
• Work with Claims and Collections in order to assist patients and their families with billing and payment activities

Manager

• Collaborate with stakeholders to define and articulate the workflow vision, strategy, and roadmap based on customer insights, and business objectives
• Manage and prioritize development backlogs, balancing customer needs, technical constraints, and business goals
• Work closely with operations, development, and business intelligence teams to ensure alignment and successful execution of product initiatives
• Clearly communicate workflow updates, plans, and features to internal teams, customers, and other stakeholders
• Plan and execute workflow launches in collaboration with operations and development teams to ensure maximum adoption and success

RCM Workflow Manager

Operations

• Set the strategy for technology growth and partner with development teams on new solutions for determining best technology, including AI/RPA and automation
• Preserve and enhance top line revenue associated with our Insurance line of business (LOB) for all locations within Meduit
• Maximize client performance and profitability of the respective service line, that is derived from the associated top line revenue
• Ensure the highest standards of customer service, process innovation, technology maximization and operational effectiveness are being achieved so that superior service is delivered to the client while also executing on the utmost of operational effectiveness and efficiency
• Serve as the national leader and subject matter expert for the Insurance LOB across multiple Meduit sites and work to promote a combined insurance organization
• Provide input on pricing new business and financial modeling for complexity and liquidation with understanding the profitability of LOB. Participate in problem solving for clients who are not meeting their profitability targets
• Oversee and improve the end-to-end operating model for new client intake, configuration and ongoing service protocols to ensure that we deliver service at or above the levels we committed to

VP of Operations, Insurance

• Reduce outstanding accounts receivable by managing claims inventory
• Speak to patients and insurance companies in a professional manner regarding their outstanding balances
• Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs, etc.
• Request, input, verify, and modify patient’s demographic, primary care provider, and payor information
• Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
• Utilize various databases and specialized computer software for revenue cycle activities
• Explain charges, answer questions, and communicate requirements regarding patient financial care services

Insurance Specialist – Prior Authorization

Implementation Specialist

• Implement client data, implement new features on existing clients, and assist in data integrity for all clients
• Implement client Revenue Cycle data into applicable applications based off project requirements including Benchmark and systems applications
• Create and configure ETL processes from multiple data sources in complex formats
• Log, track, and document solutions to complex data implementation tasks in Jira
• Build custom data transformation processes using commercial ETL tools
• Develop new logical data model schemas and tables for the creation and use of physical data model schemas and tables
• Attend client project virtual meetings focused on gathering requirements and communicating project progress and timelines
• Mentor other Team Members on data implementation solutions

Data Implementation Engineer

• Oversee the successful delivery of complex client onboarding and implementation initiatives
• Manage a team of implementation specialists and managers
• Ensure operational excellence
• Partner closely with cross-functional leaders to deliver high-quality solutions
• Provide strategic direction and drive process improvements
• Ensure implementation projects are delivered on time and within scope

Senior Manager – Implementations

Vice President

• Manage key customer relationships, becoming both a client advocate internally and serving as the main contact for the client, with the ultimate goals being client retention and client growth
• Monitor performance, ensuring that SLAs are met/exceeded while managing internally with Operations to ensure a consistent delivery of high performance and maintaining acceptable margins associated with a client’s budgeted financial performance
• Develop strong relationships with multiple contact levels at the client, connecting with key business executives and stakeholders with a focus on the top executive levels
• Ensure that Meduit has regularly scheduled business reviews (monthly, quarterly, etc.) with the client to discuss performance reports and KPIs, patient satisfaction, and address outstanding needs
• Work within the client base to provide additional upgrade sales by always listening to client problems and demonstrating Meduit solutions across the Continuum, working with Outside Sales as needed
• Manage Relationship Managers as their direct supervisor as necessary
• Assist in developing creative and effective sales and client collateral in partnership with the marketing team
• Attend appropriate conferences and sales forums to maximize the exposure of Meduit’s services

Vice President, Client Engagement

Customer Support

• Helping patients understand financial responsibility in a helpful and non-threatening manner
• Taking inbound and making outbound calls to patients regarding outstanding balances
• Meeting or exceeding established metric goals
• Following established procedures to resolve patient account balances
• Documenting all conversations electronically on company and/or client systems
• Assisting patients in determining eligibility for financial assistance programs

Medical Customer Service Representative

• Manage key customer relationships, becoming both a client advocate internally and serving as the main contact for the client
• Monitor performance, ensuring that SLAs are met/exceeded while managing internally with Operations
• Develop strong relationships with multiple contact levels at the client
• Ensure that Meduit has regularly scheduled business reviews with the client
• Work within the client base to provide additional upgrade sales
• Manage Relationship Managers as their direct supervisor as necessary
• Assist in developing creative and effective sales and client collateral
• Be fully aware of our operational performance and work with leaders in Operations on problem resolution

Content Creator

• Design courses using adult learning principles and integrate interactive concepts/activities in both instructor-led and distance formats to encourage knowledge application and skill development
• Ensure the instructional integrity of training projects through systematic design and clear writing of scripts, narratives, on-screen text, and/or selection of third-party content/resources
• Create, revise, and update multi-media training materials according to system, design, and policy & procedure changes
• Incorporate alternative training methods, such as video conference, web, and e-learning
• Work closely with the Instructional Designer to ensure training materials are ready for new client implementations
• Assist with the development of assessments that correlate with learner outcomes

Content Developer

QA Engineer

• Conduct audits across multiple projects to assess account accuracy, documentation quality, billing and coding practices, and adherence to standard operating procedures and workflows
• Verify claims, validate data integrity, and evaluate compliance with regulatory and client specific guidelines specific guidelines
• Analyze audit results to identify error trends, discrepancies, and opportunities for improvement
• Document clear, accurate audit findings and recommendations, highlighting training needs and process improvement opportunities
• Provide reporting and feedback to Operations to support performance improvement and compliance
• Maintain strict confidentiality and security of patient and company information
• Meet established daily, weekly, and monthly productivity and quality targets

Insurance QA Specialist

Systems Engineer

• Support our healthcare partners & help them thrive at Meduit!
• Responsible for initial implementations and ongoing configuration tasks related to our technology platforms and specifically Artiva HCx.
• Close collaboration with Operations, Data, Technical Support, Project Management, Account Management, and other internal teams to ensure product needs are met for all end users, both pre- and post-implementation.
• Collaborate with Operations, Clients, Development, and Data teams to ensure all necessary data is obtained from clients.
• Conduct initial business process analysis to define new processes or projects.
• Assist in designing configurations to support internal and client business processes on our application platforms.
• Build finalized product configurations and set up initial users for new implementations.
• Lead support for project and user configurations during the stabilization phase.
• Assist the Support team with escalated or complex product-related issues.
• Optimize software configurations for internal and client end users.
• Maintain strong knowledge of related systems for configuration, user training, and troubleshooting.
• Resolve impediments independently and escalate challenges to management as needed.
• Act as a subject matter expert for system/configuration capabilities.
• Manage and complete assigned projects independently.
• Ensure documentation is created and updated as appropriate.
• Assist with the collection of product and feature definitions, including enhancements to existing products.

Insurance Specialist – Eastern & Central Time Zones

Insurance Specialist – Credit Resolution

Insurance Specialist – Eastern & Central Time Zones

Insurance Specialist – Credit Resolution

RCM Workflow Manager

VP of Operations, Insurance

Insurance Specialist – Prior Authorization

Data Implementation Engineer

Senior Manager – Implementations

Vice President, Client Engagement

Medical Customer Service Representative

Vice President, Client Engagement

Content Developer

Insurance QA Specialist

HCx Systems Analyst