Senior RCM Process Specialist

Join the Team Modernizing Medicine At ModMed, we’re not just building software—we’re reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: we hired doctors and taught them how to code. This "for doctors, by doctors" philosophy has allowed us to create an AI-enabled, specialty-specific cloud platform that places patients at the center of care. A Culture of Excellence When you join ModMed, you’re joining an award-winning team recognized for innovation and employee satisfaction. From our global headquarters in Boca Raton Florida, and extensive employee base in Hyderabad India, we are a team of 4,500+ passionate problem-solvers on a mission to increase medical practice success and improve patient outcomes: Consistently ranked as a Top Place to Work 2025 Globee Business Awards: Gold Globee for “Technology Team of the Year” 2025 Black Book Awards: Ranked #1 EHR in 11 Specialties Florida Venture Forum: Venture-Backed Company of the Year We are growing fast, thinking big, and we are just getting started. Ready to modernize medicine with us?

Job Description

Summary: ModMed is hiring a driven Senior RCM Process Specialist to join our positive, passionate, and high-performing RCM (aka BOOST) Team. This individual will be a key contributor to optimizing revenue cycle management (RCM) workflows and systems. The role involves analyzing current processes, identifying areas for improvement, implementing solutions, and ensuring efficient and compliant revenue capture for our healthcare clients. Your Role: Conduct in-depth analysis of existing RCM processes across various stages, including patient registration, charge entry, claims submission, payment posting, denial management, and accounts receivable follow-up. Identify bottlenecks, inefficiencies, and compliance risks within RCM workflows and propose data-driven solutions. Develop and implement process improvements, standard operating procedures (SOPs), and best practices to enhance RCM performance and maximize revenue. Collaborate with cross-functional teams, including product development, client success, and operations, to integrate process changes and system enhancements. Design and deliver training programs for internal teams and clients on new RCM processes and system functionalities. Monitor key RCM performance indicators (KPIs) and provide regular reports on process effectiveness and areas for further optimization. Stay abreast of industry trends, regulatory changes, and technological advancements in RCM to ensure Modernizing Medicine's solutions remain competitive and compliant. Participate in client-facing discussions to understand RCM challenges and provide expert guidance on process improvements. Assist in the development and documentation of RCM product requirements based on process analysis and client feedback. Troubleshoot complex RCM issues and provide advanced support to internal teams and clients. Skills & Requirements Bachelor's degree in Healthcare Administration, Business, Finance, or a related field. Minimum of 5 years of progressive experience in Revenue Cycle Management, with a focus on process analysis and improvement. Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), claims processing, and denial management. Proven experience in identifying process inefficiencies and implementing effective solutions. Excellent analytical, problem-solving, and critical thinking skills. Proficiency in RCM software and electronic health record (EHR) systems; experience with Modernizing Medicine's products is a plus. Strong communication (written and verbal) and interpersonal skills, with the ability to effectively interact with all levels of staff and clients. Ability to work independently and as part of a team in a fast-paced, dynamic environment. Project management experience or familiarity with project management methodologies is desirable. Certification in healthcare revenue cycle (e.g., CRCR, CHFP) is a plus. ModMed Benefits Highlight: At ModMed, we believe it’s important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: United States Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution, 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address ([email protected]). Please check senders’ email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.