[Hiring] Senior HME RCM Specialist @Prochant US

Role Description

The Senior HME RCM Specialist is responsible for providing thought leadership, quality assurance, and advanced expertise in billing and collections within Prochant’s HME Division. In addition to managing reimbursement tasks, the senior HME RCM specialist acts as a mentor and trainer for other global reimbursement specialists, supporting their professional growth and development. Serving as a liaison between reimbursement specialists and the Reimbursement Manager, they help streamline operations, resolve challenges, and assist with complex projects. This position is crucial in fostering a collaborative, high-performing team environment while supporting the division’s strategic growth objectives.

• Overseeing timely and accurate processing of HME reimbursement claims, ensuring clean claim submission and follow-up with health plans.
• Serving as a flexible, highly adaptable resource across the HME team, addressing emerging challenges, escalated client concerns, process breakdowns, and operational priorities.
• Utilizing billing software, payer portals, and data reporting tools to manage outstanding A/R and enhance cash collections.
• Mentoring and training global reimbursement specialists, providing guidance on best practices and strategies for resolving billing challenges.
• Acting as a liaison between team members and management, assisting with escalated client concerns.
• Conducting quality assurance checks to ensure claim accuracy, compliance, and efficiency in reimbursement processes.
• Proactively identifying potential roadblocks affecting clients or Prochant, escalating or resolving them in a timely manner.
• Maintaining strong relationships with Reimbursement Manager, responding to inquiries with professionalism and clarity.
• Prioritizing responsibilities, managing workload effectively, and adapting to changing priorities while maintaining focus on deadlines and outcomes.
• Collaborating with offshore teams and participating in efforts to support organizational needs.
• Supporting special projects, process improvement initiatives, and cross-functional efforts that contribute to operational excellence and client satisfaction.

Qualifications

• High School diploma or equivalent required.
• Minimum 2 years of experience in home HME billing and collections.
• Experience using Brightree, CPR+, CareTend, or WeInfuse software preferred.
• Strong written and verbal communication skills with an ability to mentor and train others.
• Demonstrated initiative and problem-solving ability.
• Deep knowledge and experience billing and collecting major medical claims for home HME, ambulatory HME, and/or specialty pharmacy.
• Ability to demonstrate a clear understanding of CMS 1500 and 837 claim formatting and billing process.

Benefits

• Health Insurance
• Gap Insurance
• Dental Insurance
• Vision Insurance
• Short Term/Long Term Disability (company paid)
• Term Life Insurance (company paid, employee can elect additional)
• Disability Income
• Level Term Life
• Accident Insurance
• Critical Illness Insurance
• Floating holidays and paid time off
• 401K with Company match
• Family Teledoc Plan (Company Paid)