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Rcm Specialist | India

2+ years
Not Disclosed
10 Nov. 13, 2024
Job Description
Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Revenue Cycle Specialist

Qualification & Desired Candidate Skills:

  • Intermediate or Bachelor’s degree
  • 4-6 years of experience in end-to-end AR (Accounts Receivable) process
  • Experience in Charge Posting & Payment Posting is a plus
  • Strong knowledge of healthcare billing regulations, coding guidelines, and payment systems
  • Excellent analytical and problem-solving skills
  • Strong attention to detail and accuracy
  • Effective communication skills to interact with insurance companies, patients, and stakeholders
  • Ability to work independently and as part of a team
  • Proficient in Microsoft Office and other relevant software applications
  • Shift Timings: 6:00 PM IST to 3:00 AM IST

Responsibilities:

  • Manage and oversee the revenue cycle process, from charge capture to payment posting
  • Review and analyze claims for accuracy and completeness before submission to payers
  • Ensure compliance with billing regulations and coding guidelines
  • Identify and resolve issues with denied or rejected claims
  • Follow up on unpaid claims and collections to ensure timely payment
  • Communicate with insurance companies, patients, and stakeholders to resolve billing & coding issues
  • Collaborate with healthcare providers to ensure accurate charge capture and documentation
  • Analyze billing and payment data to identify trends and opportunities for improvement
  • Work with healthcare professionals, including physicians and nurses, to ensure effective revenue cycle management
  • Stay up-to-date on changes to healthcare regulations, coding guidelines, and payment systems
  • Handle Protected Health Information in compliance with the Health Insurance Portability and Accountability Act (HIPAA)
  • Perform other duties as assigned