RCM Integration Director

Job Summary/Objective:

As 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 to oversee 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 using 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/supervisors

Work Environment and Physical Demands
Hybrid work environment

Travel
As Needed

Required Education and Experience

Education:

• 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.

Experience:

• 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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