RCM Client Services Specialist

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.

This is a remote position.

Essential Functions / Tasks / Duties / Responsibilities:

• 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.

Competencies

• Problem solving skills
• Decision Making skills
• Strong communication skills
• Able to talk to speak with clients and employees in a professional, meaningful manner

Education / Professional Certifications or Licenses Required:

• College Degree, Professional Certifications and / or some combination of related experience
• CPC (a plus)

Experience Requirements:

• 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

Work Environment / Physical demands/ Travel Requirements:

• Computer use in a remote environment
• Minimal lifting requirements
• Travel to conferences and remote offices
• Nights and weekend as needed

Equal Employment Opportunity Statement:

Our company is committed to equal employment opportunity. We will not discriminate against employees or applicants for employment on any legally recognized basis [“protected class”] including, but not limited to: veteran status, uniform service member status, race, color, ancestry, pregnancy, childbirth and related medical conditions, national origin, non-job related handicap or disability, or the use of a guide or support animal, creed, religion, sex, sexual orientation, national origin, age [18 and over] - [40 or over], physical or mental disability, predisposing genetic characteristics, military status, marital status, protected action, concerted activity, or any other protected class under federal, state or local law. You may discuss equal employment opportunity related questions with your supervisor or any other member of management.

Americans with Disabilities Act Statement:

Our company is committed to providing equal employment opportunities to otherwise qualified individuals with disabilities, which may include providing reasonable accommodation where appropriate. In general, it is your responsibility to notify your supervisor of the need for accommodation. Upon doing so, your supervisor may ask you for your input or the type of accommodation you believe may be necessary or the functional limitations caused by your disability. Also, when appropriate, we may need your permission to obtain additional information from your physician or other medical or rehabilitation professionals.