Medical Coding Revenue Cycle Case & Escalation Management Sr Associate

Position Summary:

Join our dynamic Revenue Cycle Case and Escalation Management (RCCEM) team, where you will play a pivotal role in tackling our most complex and sensitive client issues. As the final escalation point, our team is dedicated to researching and resolving challenges that require a keen eye for detail and a commitment to excellence. This role specifically needs to be filled by an individual with experience in Medical Coding.

In this role, you will be at the forefront of driving actionable insights across Product and Revenue Cycle Management, ensuring that our product and services not only meet but exceed athenahealth's value proposition and the expectations of our clients. Your contributions will be essential in creating visibility into case performance, fostering consistency in terminology and measurement, and championing initiatives that enhance case resolution performance.

At athenahealth, we pride ourselves on our innovative spirit and solution-oriented mindset. We thrive in a collaborative environment that embraces continual change and improvement, fueled by our rapid growth. If you are a naturally curious individual with a strong desire to learn and grow, this is the perfect opportunity for you to make a significant impact while collaborating with passionate colleagues. Join us in shaping the future of healthcare solutions!

Essential Functions (Duties and Responsibilities):

Customer Focus

• Follows team expectations and methodology to manage complex issues and escalations to resolution using the CRM platform (Salesforce).
• Maintains consistent communication with internal and external stakeholders including direct customer communication.
• Provides constructive feedback to improve service delivery, service offerings, and product outcomes.

Analytical Thinking

• Leverages wide breadth of existing tools and resources efficiently and effectively to troubleshoot issues.
• Suggests workflow and quality improvements to reduce case inflow and improve client sentiment.
• Contributes to team initiatives to improve department processes and tools.

Plans and Aligns (Project Management)

• Develops a plan identifying tasks and reasonable timelines
• Determines appropriate prioritization for completing work.
• Assigns tasks appropriately across teams.
• Identifies potential obstacles or challenges that could impact the completion of tasks.

Mentor Others

• Promotes continuous learning by taking the lead in team discussions, fostering an environment for knowledge sharing and best practices.
• Mentors peers in effective escalation and project management by offering support, validating their work, providing constructive feedback, and shadowing them during calls.

Education & Experience Required:

• An ideal candidate will have medical billing/US healthcare experience or have demonstrated the ability to rapidly learn the foundational concepts of US healthcare and medical billing.
• Bachelor's degree or equivalent experience
• Certified Professional Coder (CPC) or equivalent

Knowledge & Skills:

• Customer-centric mindset characterized by empathy, collaboration, and advocacy.
• Strong written and verbal communication skills, enabling effective interaction with all organization level and stakeholders.
• Expertise in problem-solving, with the ability to analyze large data sets to identify root causes and trends.
• Proven capability to analyze data, surface trends and insights, and provide actionable recommendations.
• Ability to work independently and as part of a team, knowing when to involve others for effective problem-solving.
• Strong project management skills, including planning and aligning tasks, resources, and timelines.
• Tenacious and accountable, able to navigate complexity and overcome obstacles.
• Knowledgeable in coding systems (ICD-10, CPT, HCPCS), medical terminology, anatomy, and physiology.
• Proficient in Excel and other business tools (Smartsheets, Google tools, SharePoint, etc.)