Experienced RCM Customer Service Manager – Healthcare Operations and Customer Experience
At careerzynith, we're revolutionizing the way people experience cancer care. Our team of healthcare, technology, and consumer industry experts are dedicated to making cancer care a more human experience. With a passion for innovation and a commitment to excellence, we're rapidly adding talent to our team – come join us!
**About careerzynith**
careerzynith Health pairs people experiencing cancer with American Cancer Society-certified counselors for virtual, 1-on-1 support. Our mission is to provide personalized, compassionate care that empowers individuals to take control of their cancer journey. With a strong foundation in digital health, oncology, customer-centered design, and data science, we're pushing the boundaries of what's possible in cancer care.
**Role and Responsibilities**
As an Experienced RCM Customer Service Manager, you'll play a critical role in driving the growth of revenue, technical productivity, and promoting high-quality satisfaction while building relationships (internal and external) and ensuring the integration of strategic plans with company operations. Your responsibilities will include:
* Verifying insurance: Checking the status of new and existing patients' insurance, and updating information as needed
* Obtaining pre-authorization: Calling to get pre-approval for recommended services and procedures
* Explaining financial responsibilities: Informing patients of their financial obligations
* Educating patients: Teaching patients about their insurance coverage
* Informing clinical staff: Notifying relevant clinical staff of denials
* Answering questions: Answering questions about billing and insurance
* Calculating cash estimates: Estimating cash for patients' upcoming visits or procedures
* Verifying customer and insurance data: Reviewing, correcting, deleting, or reentering data
* Maintaining confidentiality: Protecting patient information and maintaining customer confidence
* Strong understanding of medical terminology, such as CPT codes, diagnoses, and treatments
* Ability to interact with patients and insurance companies over the phone and in person
* Reviewing batch claims for submission
* Reviewing and working ERAs and denials
* Collecting co-payment, deductible, co-insurance and posting payments
**Knowledge, Skills, and Abilities Required**
To succeed in this role, you'll need:
* 3-5 years of experience in each domain:
+ Customer/member service experience preferably from a health plan with a high-volume call center
+ Provider Relations - experience dealing with provider calls and handling referrals
+ Claims and billing – experience with insurance verification, member benefits and eligibility, explanation of benefits, ERA, etc.
+ General administrative skills – Microsoft, Google docs, etc.
* Strong communication and interpersonal skills
* Ability to work in a fast-paced environment with multiple priorities
* Strong analytical and problem-solving skills
* Ability to maintain confidentiality and handle sensitive information
**Benefits and Perks**
As an careerzynith team member, you'll enjoy a range of benefits and perks, including:
* Flexible Paid Time Off (PTO)
* Health, Dental and Vision Insurance
* Short Term / Long Term Disability
* Life Insurance
* 401(k) Retirement Plan
* Flexible Spending Accounts
* Employee Assistance Program
* And more...
**Conditions of Employment**
To be eligible for this role, you must:
* Be authorized to work in the United States
* Pass a background check as a condition of employment
**Equal Employment Opportunity Policy**
careerzynith Health, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
**Join the careerzynith Team**
If you're passionate about making a difference in the lives of people experiencing cancer, we want to hear from you! Apply now to become a part of our dynamic team and help us revolutionize the way people experience cancer care.
Apply To this Job
Apply for this job
**About careerzynith**
careerzynith Health pairs people experiencing cancer with American Cancer Society-certified counselors for virtual, 1-on-1 support. Our mission is to provide personalized, compassionate care that empowers individuals to take control of their cancer journey. With a strong foundation in digital health, oncology, customer-centered design, and data science, we're pushing the boundaries of what's possible in cancer care.
**Role and Responsibilities**
As an Experienced RCM Customer Service Manager, you'll play a critical role in driving the growth of revenue, technical productivity, and promoting high-quality satisfaction while building relationships (internal and external) and ensuring the integration of strategic plans with company operations. Your responsibilities will include:
* Verifying insurance: Checking the status of new and existing patients' insurance, and updating information as needed
* Obtaining pre-authorization: Calling to get pre-approval for recommended services and procedures
* Explaining financial responsibilities: Informing patients of their financial obligations
* Educating patients: Teaching patients about their insurance coverage
* Informing clinical staff: Notifying relevant clinical staff of denials
* Answering questions: Answering questions about billing and insurance
* Calculating cash estimates: Estimating cash for patients' upcoming visits or procedures
* Verifying customer and insurance data: Reviewing, correcting, deleting, or reentering data
* Maintaining confidentiality: Protecting patient information and maintaining customer confidence
* Strong understanding of medical terminology, such as CPT codes, diagnoses, and treatments
* Ability to interact with patients and insurance companies over the phone and in person
* Reviewing batch claims for submission
* Reviewing and working ERAs and denials
* Collecting co-payment, deductible, co-insurance and posting payments
**Knowledge, Skills, and Abilities Required**
To succeed in this role, you'll need:
* 3-5 years of experience in each domain:
+ Customer/member service experience preferably from a health plan with a high-volume call center
+ Provider Relations - experience dealing with provider calls and handling referrals
+ Claims and billing – experience with insurance verification, member benefits and eligibility, explanation of benefits, ERA, etc.
+ General administrative skills – Microsoft, Google docs, etc.
* Strong communication and interpersonal skills
* Ability to work in a fast-paced environment with multiple priorities
* Strong analytical and problem-solving skills
* Ability to maintain confidentiality and handle sensitive information
**Benefits and Perks**
As an careerzynith team member, you'll enjoy a range of benefits and perks, including:
* Flexible Paid Time Off (PTO)
* Health, Dental and Vision Insurance
* Short Term / Long Term Disability
* Life Insurance
* 401(k) Retirement Plan
* Flexible Spending Accounts
* Employee Assistance Program
* And more...
**Conditions of Employment**
To be eligible for this role, you must:
* Be authorized to work in the United States
* Pass a background check as a condition of employment
**Equal Employment Opportunity Policy**
careerzynith Health, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
**Join the careerzynith Team**
If you're passionate about making a difference in the lives of people experiencing cancer, we want to hear from you! Apply now to become a part of our dynamic team and help us revolutionize the way people experience cancer care.
Apply To this Job
Apply for this job