Elevateent
RCM Integration Director
Elevateent, Miami, Florida, us, 33222
At Elevate ENT Partners, our commitment lies in delivering exceptional patient care while prioritizing the satisfaction of our team members. We strive to attract and retain the industry's finest talent—individuals who are passionate about their roles and driven to effect meaningful change in a dynamic healthcare landscape. Explore our career opportunities below and become part of our dedicated team!An Equal Opportunity Employer and Drug Free WorkplaceAs the Director of RCM Integrations, you will play a key role in optimizing and integrating revenue cycle management processes for recently acquired practices. You will manage the RCM function for new practices: some will require long-term management under legacy EMR while others will be integrated quickly into the Elevate eClinicalWorks Enterprise Environment. You will also be responsible for overseeing clearinghouses and third-party vendors to streamline financial workflows, increase reimbursement rates, and improve overall practice efficiency of new acquisitions. This role requires a deep understanding of RCM processes, excellent technical skills, and a proactive approach to problem-solving.Essential Job Functions
Integration Management:
Serve as the primary point of contact for the integration of new acquisitions with RCM software, billing systems, and third-party vendors.Lead and oversee the successful configuration, implementation, and integration of RCM functionalities within eClinicalWorks.Work closely with IT teams and external vendors to ensure the secure and accurate transfer of data between systems.Troubleshoot integration issues, escalate problems when necessary, and work toward timely resolution.
Revenue Cycle Optimization:
Identify areas for improvement within the RCM workflow and recommend optimizations to maximize revenue capture.Ensure that EMRs are used to their full capacity in terms of billing, coding, claims management, and payment posting.Stay updated on regulatory changes, coding updates (e.g., ICD-10, CPT), and payer requirements that may impact RCM processes.
Training and Support:
Oversee training and technical support to billing and front-office staff on eClinicalWorks functionalities.Educate staff on best practices for revenue cycle management, claim submission, and denial management within eClinicalWorks.
Reporting and Analytics:
Generate regular and ad-hoc reports to analyze financial performance, including claims status, accounts receivable, and revenue trends.Assist in developing dashboards and KPIs to monitor practice performance and identify areas needing improvement.
Compliance and Documentation:
Ensure adherence to HIPAA and other compliance regulations when managing patient information and financial data.Maintain thorough documentation of integration setups, workflows, and any customizations applied to eClinicalWorks and other EMRs (e.g., ModMed).Monitor system updates and changes in payer rules to keep the RCM process compliant.
Supervisory Responsibility
Integration specialists, local practices RCM manager/supervisorsWork Environment and Physical Demands
Hybrid work environmentTravel
As NeededRequired Education and Experience
Bachelor’s degree in healthcare administration, information technology, or a related field (preferred).Certifications in RCM, medical coding, or billing (e.g., CPC, CRCR) are a plus.7+ years of experience in revenue cycle management, preferably within a healthcare setting.At least 2 years of hands-on experience with
eClinicalWorks
in an RCM role.Proven experience with integration and implementation of healthcare systems (especially EMRs and billing software).Technical Skills
Strong proficiency in
eClinicalWorks , including EHR and PM functionalities.Familiarity with medical billing, coding (ICD-10, CPT), claim submission, and denial management workflows.Experience with API integrations, clearinghouses, and third-party systems relevant to RCM.Experience with ModMed and Athena EMRs a plus.Proficiency in Excel, SQL, or other data analysis tools.
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Integration Management:
Serve as the primary point of contact for the integration of new acquisitions with RCM software, billing systems, and third-party vendors.Lead and oversee the successful configuration, implementation, and integration of RCM functionalities within eClinicalWorks.Work closely with IT teams and external vendors to ensure the secure and accurate transfer of data between systems.Troubleshoot integration issues, escalate problems when necessary, and work toward timely resolution.
Revenue Cycle Optimization:
Identify areas for improvement within the RCM workflow and recommend optimizations to maximize revenue capture.Ensure that EMRs are used to their full capacity in terms of billing, coding, claims management, and payment posting.Stay updated on regulatory changes, coding updates (e.g., ICD-10, CPT), and payer requirements that may impact RCM processes.
Training and Support:
Oversee training and technical support to billing and front-office staff on eClinicalWorks functionalities.Educate staff on best practices for revenue cycle management, claim submission, and denial management within eClinicalWorks.
Reporting and Analytics:
Generate regular and ad-hoc reports to analyze financial performance, including claims status, accounts receivable, and revenue trends.Assist in developing dashboards and KPIs to monitor practice performance and identify areas needing improvement.
Compliance and Documentation:
Ensure adherence to HIPAA and other compliance regulations when managing patient information and financial data.Maintain thorough documentation of integration setups, workflows, and any customizations applied to eClinicalWorks and other EMRs (e.g., ModMed).Monitor system updates and changes in payer rules to keep the RCM process compliant.
Supervisory Responsibility
Integration specialists, local practices RCM manager/supervisorsWork Environment and Physical Demands
Hybrid work environmentTravel
As NeededRequired Education and Experience
Bachelor’s degree in healthcare administration, information technology, or a related field (preferred).Certifications in RCM, medical coding, or billing (e.g., CPC, CRCR) are a plus.7+ years of experience in revenue cycle management, preferably within a healthcare setting.At least 2 years of hands-on experience with
eClinicalWorks
in an RCM role.Proven experience with integration and implementation of healthcare systems (especially EMRs and billing software).Technical Skills
Strong proficiency in
eClinicalWorks , including EHR and PM functionalities.Familiarity with medical billing, coding (ICD-10, CPT), claim submission, and denial management workflows.Experience with API integrations, clearinghouses, and third-party systems relevant to RCM.Experience with ModMed and Athena EMRs a plus.Proficiency in Excel, SQL, or other data analysis tools.
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