Experience & Qualifications

• 3–5+ years of experience in healthcare Revenue Cycle Management (RCM), within physician/professional billing.
• Demonstrated experience implementing and onboarding new RCM clients, from initial kickoff through successful go-live and stabilization.
• Strong understanding of the full physician revenue cycle, including patient registration, eligibility, charge capture, coding, claim submission, payment posting, denial management, A/R follow-up, and patient collections.
• Experience gathering and documenting client workflows, operational requirements, payer information, provider data, and billing configurations.
• Ability to develop and manage implementation timelines, deliverables, dependencies, and client action items across multiple concurrent implementations.
• Experience coordinating payer enrollment, ERA/EFT setup, clearinghouse enrollment, EDI configuration, and provider/NPI/TIN setup.
• Ability to identify implementation risks, workflow gaps, and potential revenue-impacting issues before go-live.
• Experience validating system configuration and conducting pre-go-live testing, including claims, interfaces, reports, and financial workflows.
• Strong client-facing skills with the ability to lead kickoff calls, implementation meetings, training sessions, and executive-level status updates.
• Ability to partner effectively with internal teams including Operations, Coding, Credentialing/Enrollment, IT, EDI, Finance, and Account Management.
• Strong organizational and project-management skills with the ability to manage deadlines and competing priorities independently.
• Experience establishing implementation KPIs and monitoring early performance following go-live, including claim acceptance, clean claim rate, charge lag, payment activity, denials, and A/R trends.
• Ability to create and maintain implementation documentation, SOPs, workflow diagrams, issue logs, and transition documentation.
• Strong analytical and problem-solving skills with proficiency in Excel and healthcare reporting/data analysis.
• NextGen experience required; NextGen Enterprise experience is required.
• Experience with clearinghouses, payer portals, and EDI workflows preferred.
• Knowledge of HIPAA, CMS requirements, payer billing guidelines, and healthcare compliance standards.
• Bachelor’s degree preferred; equivalent RCM experience or certifications may be considered in lieu of a degree.