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RCM Functional Lead

New York, NY, US • Posted 7 hours ago • Updated 7 hours ago

Contract W2

On-site

Depends on Experience

Fitment

Dice Job Match Score™

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Job Details

Skills

Summary

A client of Innova Solutions is immediately hiring for a “RCM Functional SME"

Position Type: Full-Time Contract (W2)
Role: “RCM Functional SME”
Duration: 3+ Months Contract
Location : New York, NY – (Remote/Travel)

Must have required skills – RCM Automation, (Revenue Cycle Management), Backend Patient Financial Services (PFS) Expertise, AR Follow-Up & Revenue Recovery, Healthcare Revenue Cycle Data & Transaction Knowledge, Process Translation, Automation & AI Review

Primary Skill Required for the Role:

Team lead or supervisor-level experience (minimum) in backend PFS: denials, AR follow-up, underpayment identification, payment posting/reconciliation, or claims/billing
Working fluency in CARC/RARC denial codes, payer contract and fee schedule terms, timely filing and appeal deadlines, 835/837 remittance data, AR aging and collection probability, write-off versus adjustment classification, credit balance resolution and refunds, and coordination of benefits (COB)
Understanding of upstream billing and claims concepts that affect backend outcomes: 271 eligibility responses, 277CA claim acknowledgments, claim holds and edits, clearinghouse rejections, and how a missed edit upstream turns into a downstream denial

Details:
• Partner directly with our engineering team to translate real desk-level workflows into system logic: what a denial specialist checks before deciding to appeal versus write off, how an AR rep prioritizes a work queue, how an underpayment gets flagged and disputed, how self-pay balances get tracked toward payment plan or bad debt
• Answer the engineering team''s questions about how billing and AR decisions actually get made, including payer policies, contract terms, denial code mappings, timely filing rules, and escalation thresholds
• Help build a reference library (policies, templates, procedures) the AI can pull from
• Write up how you do the job today, in a way that can be turned into clear rules and instructions
• Review AI-drafted output (appeal drafts, dispute packages, classification decisions) for accuracy against how a real specialist would handle the account

The ideal candidate will have: 10+ years of experience in RCM, and AR follow ups and Backend Patient Financial Services (PFS) Expertise.

Qualified candidates should APPLY NOW for immediate consideration!
This position is only open to applicants who can be engaged on a W-2 basis.
Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.
Thank you!

Suraj Yadav
8133491784
Suraj.Yadav@innovasolutions.com
PAY RANGE AND BENEFITS:
Pay Range*: $60 - $65/- Per Hour
*Pay range offered to a successful candidate will be based on several factors, including the candidate''s education, work experience, work location, specific job duties, certifications, etc.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions:

Named One of America’s Best Employers for New Grads by Forbes (2024)
Named One of the Best Companies to Work for by U.S. News & World Report (Private Companies List, 2024-2025)
One of the Largest IT Staffing Firms in the US – Ranked #3 by Staffing Industry Analysts (SIA, 2024)
One of the Largest Staffing Firms in the US – Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
AWS Advanced Tier Services Partner with 100+ certifications

Website: https://www.innovasolutions.com/

Innova Solutions offers a referral bonus for qualified Ambassadors who refer eligible referrals. Submit referrals at https://innovasolutions.workllama.com/atsuser/anonreferafriend and earn $250-$1,000 per referral.
Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.
The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.
By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Innova Solutions and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at Privacy Policy - innovasolutions.com

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 10115307
Position Id: 1023158
Posted 7 hours ago

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