Senior Medical Claims Expert

2 weeks ago

Chennai, Tamil Nadu, India beBeeRevercyclemangement Full time US$ 60,000 - US$ 80,000
Revenue Cycle Management Specialist

We are seeking a skilled and detail-oriented Revenue Cycle Management Specialist to join our team and contribute to efficient revenue cycle management.

  • This role involves supervising a team of billing specialists, coordinating with various departments, and optimizing billing procedures to enhance overall revenue cycle efficiency.

The responsibilities of this role include:

  • Overseeing the accurate and timely processing of claims, ensuring compliance with payer guidelines and regulations.
  • Reviewing and addressing billing discrepancies, rejections, and denials, implementing corrective actions as needed.
  • Developing and implementing billing policies and procedures to improve accuracy and efficiency.
  • Collaborating with coding, compliance, and other departments to ensure accurate coding and documentation.
  • Analyzing billing data and metrics to identify trends, issues, and opportunities for process improvements.
  • Ensuring proper follow-up on unpaid or denied claims and managing the appeals process.
  • Overseeing the use of billing software and electronic health record (EHR) systems, ensuring they are up-to-date and functioning properly.
  • Staying informed about changes in U.S. revenue cycle management practices and federal regulations to ensure billing processes remain compliant and optimized.
  • Providing guidance and training to the billing team on evolving industry standards and policy updates.
Requirements
  • Bachelor's degree in business administration, Healthcare Administration, Finance, or a related field is required. Advanced degrees or certifications (e.g., Certified Professional Biller (CPB)) are a plus.
  • Proven experience with billing systems, payer guidelines, and regulatory compliance.
  • Strong understanding of U.S. revenue cycle management, including billing workflows, reimbursement methodologies, and common challenges.
  • Up-to-date knowledge of federal regulations, policy changes, and industry standards impacting medical billing practices.
  • Familiarity with billing software and electronic health records (EHR) systems.
  • Strong attention to detail, analytical skills, and the ability to work independently.
  • Excellent communication and collaboration skills.

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