RCM Specialist

4 weeks ago

Chennai, India CapMinds Full time
Company Owerview:
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.
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.
Requirements:
- 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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