[Hiring] RCM Consultant @Vituity

Role Description

• Serve as the primary point of contact with insurance carriers, independent physician networks (IPNs), and payer representatives regarding participation, reimbursement, and contract-related matters.
• Verify patient insurance eligibility, benefits, prior authorization requirements, and estimated financial responsibility.
• Educate patients on insurance benefits, deductibles, co-payments, coinsurance, and outstanding balances.
• Review clinical documentation to support accurate coding and reimbursement, collaborating with providers to obtain documentation clarification when needed.
• Assign and review ICD-10, CPT, and HCPCS codes to ensure accurate and compliant coding.
• Prepare, submit, and monitor insurance claims while ensuring compliance with payer requirements and filing deadlines.
• Manage accounts receivable by following up on outstanding claims, communicating with payers, submitting documentation, and researching claim status.
• Post insurance payments, reconcile remittance advice, and process contractual adjustments.
• Investigate, appeal, and resolve denied, rejected, or underpaid claims.
• Generate patient statements, reconcile patient balances, and assist with account resolution.
• Coordinate collection activities and facilitate referrals to approved third-party collection agencies, when appropriate.
• Maintain compliance with all payer, regulatory, and organizational billing and coding standards.
• Prepare and analyze reports related to accounts receivable, denials, reimbursement trends, and revenue cycle performance.
• Optimize reimbursement and revenue collections.
• Reduce claim denials and aging accounts receivable.
• Ensure timely and accurate claim submission and follow-up.
• Support compliant coding and billing practices.
• Identify revenue cycle improvement opportunities and recommend process enhancements.
• Provide regular reporting and updates on revenue cycle performance metrics.

Benefits

• Monthly wellness events and programs such as yoga, HIIT classes, and more.
• Trainings to help support and advance your professional growth.
• Team building activities such as virtual scavenger hunts and holiday celebrations.
• Flexible work hours.
• Opportunities to attend Vituity community events including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more.

Company Description

At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our culture by working together to tackle healthcare’s most pressing challenges from the inside.

Vituity has opportunities at 900 practices across the country, serving 14.5+ million patients a year. With Vituity, if you ever need to move, you can take your job with you.

Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.