RCM Client Services Specialist

6 days ago

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Description

• The Client Services Specialist (CSS) oversees the revenue cycle for assigned clients and is responsible to ensure clients meet targets for KPIs, retention, and time to revenue. • The CSS will serve as the primary point of contact and liaison between the practice and the Sutherland Global RCM team. • The CSS is responsible for owning client relationships related to the revenue cycle, driving revenue improvements for practices, providing guidance and education to the Sutherland team. • Establish a strategic advisor relationship with clients by understanding their practice’s billing requirements, long term strategy, and goals. • Proactively provide insight on the financial health of their business and guidance on solutions and steps to bridge the gap to ensure their goals are achieved. • Complete business review presentations with clients to effectively communicate practice financial health, determine current level of client satisfaction and identify opportunities to improve the revenue cycle. • Report monthly denial and rejection trends internally and externally and recommend process improvements to prevent future denials and rejections. • Act as primary client point of contact to handle individual needs, resolve conflicts, and provide solutions to customers in a timely manner. • Exercise sound judgment and make independent business decisions related to solving client related billing matters. • Approve and implement workflow modifications to meet client needs that may have significant financial impact to OP and/or the practice. • Develop and monitor action plans related to client escalations/concerns. • Identify at-risk clients and determine actions required to resolve concerns and retain clients. • Provide guidance and education to the Sutherland team on clarifications, help items, and resolving outstanding AR. • Collaborate with RCM and Sutherland leadership on quality/productivity/TAT barriers. • Establish and maintain system parameters that support timely submission of claims to payers resulting in payment maximization that is both efficient and effective. • Improve operational efficiencies to include OP software performance and assist with automation initiatives. • Independently identify and resolve process shortfalls. • Collaborate with Account Managers to optimize use of OP software and identify client training needs. • Ensure success of newly implemented clients with enhanced monitoring of clients for the 6 weeks post go-live. • Complete off boarding process for clients exiting RCM services. • Maintain expert knowledge of payer guidelines for assigned geographic areas in collaboration with payer rules specialist and team leads. • Maintain functional knowledge of OP enhancements and improvements. • Communicate directly with clients to explain OP functionality related to practice management. • Maintain up-to-date awareness of healthcare industry standards and the overall landscape of pediatric medicine.

Requirements

• College Degree, Professional Certifications and / or some combination of related experience • CPC (a plus) • 5 years of Medical Billing / RCM experience • 5 years of EMR experience • 5 years Customer Service • CPT and ICD10 knowledge • Experience using Microsoft Office and Google Docs