RCM (Revenue Cycle Management) Specialist

RCM (Revenue Cycle Management) Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that billing and coding processes are efficient and compliant with industry regulations. This position requires detailed-oriented professionals who can navigate complex insurance claims and reimbursement processes.

Responsibilities:

• Manage and oversee the complete billing process from claim submission to payment collection.
• Ensure accurate coding and adhere to compliance guidelines for medical billing.
• Review and resolve denied claims and appeals.
• Collaborate with healthcare providers to ensure accurate charge capture.
• Monitor accounts receivables and expedite the recovery of outstanding payments.
• Prepare regular reports on billing activities, revenue metrics and performance.

• Stay updated on changes in healthcare regulations and coding guidelines.

   

Qualifications:

• Bachelor's Degree (Preferred - Pharma & Biotech).
• Experience in medical billing and coding.
• Certification in medical billing and coding (e.g., CPC, CCS) preferred.
• Strong knowledge of healthcare regulations and insurance processes.
• Proficiency with healthcare billing software and electronic health records (EHR).

Skills:

• Medical coding (ICD-10, CPT, HCPCS)
• Claims management
• Revenue cycle management
• Denials management
• Insurance verification
• Data analysis
• Compliance knowledge
• Billing software proficiency