Revenue Cycle Management Specialist

Job Summary:

We are looking for an experienced RCM Specialist to manage end-to-end revenue cycle processes, including medical billing, claims submission, payment posting, denial management, and collections. The ideal candidate will ensure accuracy, compliance, and efficiency in financial transactions to maximize revenue and reduce claim rejections.

Key Responsibilities:

• Handle end-to-end revenue cycle processes, including charge entry, claims submission, payment posting, and account reconciliation.
• Review and verify accuracy of patient billing and insurance claims.
• Manage claim denials, rejections, and appeals efficiently.
• Follow up with insurance companies and patients on outstanding claims and balances.
• Ensure compliance with healthcare regulations, coding guidelines, and payer requirements.
• Prepare financial and performance reports related to billing and collections.
• Collaborate with internal teams to resolve billing issues and improve cash flow.
• Stay updated on payer policies, regulations, and best practices in RCM.

• Bachelor’s degree in Healthcare Administration, Finance, Business, or related field.
• 2–4 years of hands-on experience in RCM, medical billing, or healthcare finance.
• Strong knowledge of insurance claim processes, medical billing codes (ICD-10, CPT, HCPCS) with HIPPA certification, and payer regulations.
• Proficiency in billing software, EHR/EMR systems, and MS Excel.
• Strong analytical and problem-solving skills with attention to detail.
• Good communication and negotiation skills for dealing with payers and patients.