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RCCEM Escalation Manager, Enhanced Claim Resolution Management

athenahealth, Inc. is a leading provider of cloud-based enterprise software solutions for medical groups and health systems, offering electronic health records, revenue cycle management, and patient engagement tools. The company aims to simplify healthcare, improve clinical and financial outcomes, and support the shift towards value-based care.

athenahealth

Employee count: 5000+

United States only

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

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.

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.

As an Escalation Manager, you will manage your own book of business while also supporting the team by collaborating with peers to identify and eliminate barriers to resolution and assist them in navigating high-profile escalations. You will help maintain queue health, provide tools for better management and monitoring, and leverage case data to gather and deliver actionable insights to our partner teams.

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 enjoy engaging directly with people and teams, being their partner, advocate, and coach to ensure they have the right tools, relationships and confidence to navigate the evolving landscape of issue management, this is the perfect opportunity for you to make a significant impact. Join us in shaping the future of healthcare solutions!

Essential Functions (Duties and Responsibilities):

Customer Focus

  • Models the teams expectations and methodology while supporting and leading the most sensitive engagements.
  • Develops and maintains professional and productive ongoing client relationships regarding service related issues.
  • Meet with clients and stakeholders weekly, biweekly, monthly, or as necessary to provide senior level escalation engagement updates.
  • Leverages strong cross functional partnerships to advocate for changes to service delivery, service offerings and/or product.
  • Successfully balances managing individual book of business and supporting others (50/50)

Analytical Thinking

  • Develop a comprehensive business case to tell the “impact story” to create a strong sense of client benefit to facilitate effective advocacy
  • Lead team initiatives to improve department processes and tools.
  • Drives workflow and quality improvements to reduce case inflow and improve client sentiment.
  • Utilizes reporting and tools to understand and manage RCCEM book of business.

Plans and Aligns (Project Management)

  • Applies comprehensive project management skills to manage project life cycle to ensure top quality deliverables
  • Ensures critical resources are aligned and coordinated across different teams.
  • Supports the team in anticipating risk and contingencies as part of the planning process.
  • Effectively manages the queue by assigning cases according to skill level, account ownership, and ensuring a balanced workload.

Lead Others

  • Provide leadership in escalation and project management.
  • Foster team development by enhancing skills in content knowledge, de-escalation strategies, resource utilization, and creating actionable insights.
  • Work collaboratively with the Senior Manager on team performance and development opportunities.

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

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.
  • Proficient in Excel and other business tools (Smartsheets, Google tools, SharePoint, etc.)
  • Experience with athenahealth products and services a plus

About athenahealth

Our vision:In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Our company culture:Our talented  employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.

Our DEI commitment:Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.

What we can do for you:

Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative  workspaces  — some offices even welcome dogs.

We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment,full-time. With consistent communication and digital collaboration tools, athenahealthenablesemployees to find a balance that feels fulfilling and productive for each individual situation.

In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.

Learn more about our culture and benefits here: athenahealth.com/careers

https://www.athenahealth.com/careers/equal-opportunity

About the job

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Job type

Full Time

Experience level

Manager

Location requirements

Hiring timezones

United States +/- 0 hours

About athenahealth

Learn more about athenahealth and their company culture.

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At athenahealth, we are at the forefront of revolutionizing the healthcare industry through groundbreaking technology. Our vision is to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. We partner with healthcare organizations across the care continuum, from digital health start-ups to large health systems, to drive clinical and financial results. Our innovative technology includes electronic health records, revenue cycle management, and patient engagement solutions designed to eliminate friction for patients and ensure providers are paid efficiently. Through the expansion of our services and the opening of our network to other partners, care settings, and providers, we actively seek out and eliminate obstacles to a smarter healthcare experience. We are uniquely positioned to unlock and understand healthcare data from across the nation, leveraging insights to make a tangible difference for our customers and their patients.

Our commitment to innovation is embedded in our culture and our people. We believe that an environment that welcomes, develops, and promotes all employees is crucial for achieving our ambitious goals. The athenaOne cloud platform is a testament to our innovative approach, addressing critical aspects of a physician's practice with modules spanning patient engagement, revenue cycle, telehealth, payments, population health, and value-based care management. We deliver this comprehensive suite by combining powerful SaaS technology with expert services and data-driven insights derived from the country's largest single connected network. This allows us to help healthcare providers increase clinical efficiency, optimize financial performance, improve patient care outcomes, and accelerate their shift toward value-based care. By constantly developing new solutions, such as tailored offerings for specialties like women's health and urgent care, we empower clinicians to deliver the best care while enabling their practices to operate efficiently in a complex and competitive landscape. Our platform services allow for extensive customization and integration, with a library of over 750 APIs enabling third-party applications to exchange data and create unique workflows, further driving innovation and specialized user experiences.

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athenahealth hiring RCCEM Escalation Manager, Enhanced Claim Resolution Management • Remote (Work from Home) | Himalayas