Job Title: RCM Quality and Outcome Improvement Analyst
Job Type: Contractual / Temporary
Shift and Schedule: Night shift, US shift
Location: Hyderabad, Telangana
Benefits:
Health insurance
Paid holidays
Paid sick time
Paid time off
Work from home
Modernizing Medicine (WAMM) is on a mission to revolutionize healthcare. We're a team of passionate problem-solvers dedicated to improving the success of medical practices and patient outcomes through an intelligent, specialty-specific cloud platform. With a strong base in over 3400 direct and contingent team members, we are continuing our growth journey.
Our global presence includes offices in Boca Raton, FL, Santiago, Chile, Berlin, Germany, Hyderabad, India, and a remote workforce across the US. Our commitment to healthcare excellence has earned us multiple awards, including recognition in South Florida Business Journal's Best Places to Work 2024, and we are just getting started!
The RCM Quality and Outcome Improvement Analyst is crucial to the ModMed India Operations team. You will support a group of practices under one or more specialties and work on claims escalated by practice or Global Partners. Your role is to identify trends and opportunities to improve process efficiency, thus enhancing customer outcomes.
Key responsibilities:
Meet productivity targets, deliver high customer service, and ensure service delivery follows ModMed's billing and compliance processes.
Analyze claim-level trends to identify opportunities to improve workflows and reduce inefficiencies.
Set up and manage online portals as per payer requirements.
Review escalated claims, credentialing issues, and work with onshore teams to resolve problems.
Monitor AR trends, production reports, and quality issues through dashboards.
Track progress on claims inventories and ensure timely action by global partners.
Collaborate with RCM Client Advisors to improve practice-specific instructions and workflows.
Conduct regular SOP reviews and make recommendations to improve processes.
Work with global partners and internal teams to meet Service Legal Agreements (SLA).
Support new implementations and knowledge transfer for product rollouts.
5+ years of experience in RCM, with at least 2 years in a leadership or specialized role (SME, Assistant Team Lead, etc.).
Strong understanding of RCM processes and best practices (including charges, payment posting, AR follow-ups, denials, eligibility).
Familiarity with US healthcare insurance carriers like Medicare, private HMOs, PPOs, Capitation, and Workers' Comp.
Deep knowledge of ICD-10 and CPT coding guidelines.
Advanced Excel skills (formulas, pivot tables, charts, data visualization).
Exceptional communication skills, both written and verbal.
Strong understanding of the full revenue cycle process.
Ability to work US night shifts in a hybrid work model (from home and office).
Must be able to manage relationships and communication between offshore and onshore teams.
At ModMed, we offer a competitive benefits package tailored to our global workforce:
India:
Meals & Snacks: Complimentary office lunches, dinners, and healthy snacks.
Insurance Coverage: Comprehensive health, life, and accidental insurance (family included).
Allowances: Wellness allowance to support well-being and productivity.
Leave Benefits: Earned, casual, sick leaves, and bereavement leave.
Parental Leave: Paid maternity, paternity, adoption, and surrogacy leave.
Celebration Leave: Special leave to make your important days memorable.
United States:
Healthcare Benefits: Comprehensive medical, dental, and vision coverage, with a Health Savings Account (HSA).
401(k): Matching contributions and 100% vested after one year.
Paid Time Off & Parental Leave: Generous PTO and paid parental leave programs.
Life & Disability Insurance: Company-paid benefits.
Professional Development: Tuition reimbursement and access to LinkedIn Learning.
Collaborative Culture: Dog-friendly HQ, hybrid office-based roles, and global collaboration opportunities.
ModMed has been made aware of a phishing scam where imposters pose as hiring managers and offer fake job opportunities. Please ensure any job communications come from a legitimate ModMed email address (first.lastname@modmed.com). We do not ask for purchases or personal financial information during the hiring process.
Let me know if you'd like any further adjustments!
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