RCM Account Manager

Premise Health Systems Brentwood , TN 37024

Posted 6 days ago

Healthcare Without Rival

Premise Health is the world's leading direct healthcare provider and one of the largest digital providers in the country, serving over 11 million eligible lives across more than 2,500 of the largest commercial and municipal employers in the U.S. Premise partners with its clients to offer fully connected care - in-person and in the digital environment. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions.

Premise delivers value by simplifying complexity and breaking down barriers to give diverse member populations access to convenient, integrated, high-quality care. We offer more than 30 products, delivering the breadth and depth of care required to serve organizations' total populations. The result is healthcare that meets the needs of members and their families, helping them live healthier while lowering costs for organizations.

Premise offers a wide range of dynamic, purpose-driven career opportunities. We are currently looking for a RCM Account Manager to join our team.

About the role:

The Account Manager (AM) is focused on client success and is tasked with seeking opportunities to review, report on and advise clinic operations regarding strategic practice improvements. The AM must have a keen understanding of the contributing variables, practice activities and other drivers of client success KPIs. The AM is responsible for directing the work of the AR team members which will includes Billing Specialist and AR Specialists. The AM has the overall responsibility for the performance of the clinic revenue cycle KPIs (e.g. days in accounts receivable, first pass payment resolution, best practice office workflow which results in timely signed visits), subject matter expertise, and Client satisfaction ratings are the primary measures of success.

The Account Manager (AM) is the primary owner of the client and payor relationship. The AM is also responsible for providing and managing exceptional revenue cycle management service and creating highly satisfied customer experiences. The AM engages during client onboarding, works strategically, proactively and collaboratively, aligning revenue cycle operations and clinic operations to ensure effective outcomes.

Job Requirements:

  • Establishing and maintaining system parameters that support timely submission of claims to payers resulting in payment maximization that is both efficient and effective.

  • Utilizing system tools to identify at risk accounts and determine actions required by the AR team or clinic.

  • Managing Client accounts receivable, including analyzing by category and by payer and offering strategic solutions to reduce time in aging.

  • Directing the AR team on follow up work to determine unpaid claim status and taking appropriate actions to ensure prompt payment.

  • Identifying the root cause of issues impacting proper and timely first pass payment results and working with the AR team and clinic resources to implement process and system changes to drive results.

  • SME in revenue cycle management, which includes monthly and quarterly reporting to client, identifying issues affecting performance, and recommending actions to drive success.

  • Deliver exceptional customer service by resolving patient escalations timely.

  • Serves as the primary point of contact for the health center operations, and triages issues or tasks to the appropriate AR team member.

  • Collaborate with internal teams to identify improvements needed to enhance the client experience, service, product, and process to support value proposition.

  • Identifying, articulating, and championing Client needs and desires to operations management for resolution.

  • May require other duties as assigned.

Education:

  • High School Graduate minimum education requirement, BS preferred or equivalent work experience

Experience:

  • 2-3 years previous experience in healthcare account management, customer service, revenue cycle operations or accounting.

Knowledge and Skills:

  • Strong knowledge of medical billing including commercial payers, Medicare, Medicaid, workers' compensation and patient responsibility is highly desirable EPIC systems experience desirable

Work-life balance is at the foundation of how decisions are made and where Premise is headed. We can only help people get, stay, and be well if we do the same for ourselves. In addition to competitive pay, Premise offers benefits packages including medical, dental, vision, life insurance, 401(k), paid holidays and vacation time, a company-sponsored wellness program, and much more our talent acquisition team will be happy to share with you.

Premise Health is an equal opportunity employer; we value inclusion, and we do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.


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RCM Account Manager

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