RCM Executive

Company DescriptionAmbit Global Solution is a leading medical and dental billing and revenue cycle management company based in Ahmedabad. The company helps organizations maximize revenue and reduce operating costs with a highly trained team of experts. Ambit's powerful technology solutions and client-focused service enhance the efficiency and profitability of medical practices, hospitals, dental groups, GPOs, and third-party administrators. Client satisfaction is the primary focus, supported by detailed processes, experienced personnel, cutting-edge technology, and a forward-thinking approach.Job TitleAccounts Receivable Specialist – Revenue Cycle Management (RCM)Job SummaryThe Accounts Receivable Specialist under the RCM process is responsible for managing and optimizing all activities related to the collection of payments for healthcare services rendered. This includes following up with insurance carriers, addressing claim denials, posting payments, and maintaining precise financial documentation to support revenue integrity.Key Responsibilities- Manage the accounts receivable process, including billing, claims follow-up, payment posting, and collections for assigned healthcare clients. - Review AR aging reports to identify outstanding or delinquent accounts and take appropriate follow-up actions. - Investigate and resolve claim denials, discrepancies, and underpayments through communication with insurance companies and patients. - Submit and appeal claims to payers, ensuring compliance with payer-specific guidelines and regulatory requirements. - Post payments accurately into the billing system and reconcile accounts to maintain up-to-date financial records. - Communicate effectively with cross-functional teams such as billing, coding, and customer service to resolve complex issues affecting claim payment. - Generate reports on AR performance metrics such as Days Sales Outstanding (DSO), denial rates, and collection efficiency. - Maintain data accuracy and integrity in the AR management system, ensuring all patient information, claims, and payments are properly documented. - Support management during audits and compliance reviews by providing documentation and analysis as required. - Participate in process improvement initiatives to streamline AR workflows and improve overall revenue cycle performance.Required Qualifications and Skills- Bachelor’s degree in Finance, Accounting, Healthcare Administration, or a related field. - 6 + Months of experience in healthcare accounts receivable or RCM operations. - Proficiency with RCM or practice management systems (Epic, Athenahealth, eClinicalWorks, etc.) and Microsoft Excel. - Knowledge of medical billing codes (CPT, ICD-10) and insurance reimbursement processes. - Strong analytical, communication, and problem-solving skills with attention to detail. - Understanding of HIPAA regulations and payer-specific billing protocols.Performance Indicators- Reduction in AR days and increase in collection ratio. - High percentage of first-pass claim acceptance. - Timeliness and accuracy of payment posting. - Resolution rate of claim denials and rejections.This role is integral to the overall financial health of healthcare organizations, ensuring that services rendered translate into accurate and timely reimbursements — the core objective of the Revenue Cycle Management function.