RCM Specialist
1 week ago
CapMinds is a health-IT digital transformation partner for healthcare and related organizations worldwide. We provide technology research, solutions, and services for global businesses, enabling them to be more efficient, focused, and innovative.
www.capminds.com
Job Description:
We are looking for an experienced Revenue Cycle Management (RCM) Specialist with 4–5 years of proven expertise in end-to-end RCM operations. The ideal candidate will be responsible for managing and optimizing the complete revenue cycle, ensuring accuracy, compliance, and efficiency across all processes.
Key Responsibilities:
- Manage the full revenue cycle, including patient registration, insurance verification, charge capture, coding, claim submission, payment posting, denial management, and accounts receivable follow-up.
- Review patient accounts to ensure accurate ICD-10, CPT, and HCPCS coding, along with compliant billing practices.
- Investigate and resolve denied or rejected claims, coordinating timely resubmissions to minimize revenue loss.
- Collaborate with clinical teams to ensure documentation accurately supports coding and billing requirements.
- Optimize RCM processes to reduce denials, improve cash flow, and accelerate collections.
- Ensure compliance with HIPAA guidelines and payer-specific regulations.
- Prepare and present reports on billing performance, AR aging, and key revenue metrics.
- Identify and implement workflow improvements to drive efficiency and maximize revenue.
- 4–5 years of proven experience in end-to-end RCM within the healthcare industry.
- Strong knowledge of ICD-10, CPT, and HCPCS coding standards.
- Hands-on experience with EMR/EHR systems and billing software.
- Excellent analytical, organizational, and problem-solving abilities.
- Strong communication skills for effective interaction with patients, payers, and internal stakeholders.
- Expertise in insurance verification, claim submission, denial management, and AR follow-up.
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