
Senior US Medical Billing Professional
4 days ago
Job Overview:
We are seeking a seasoned US Medical Billing professional to establish, lead, and manage a new RCM team in India. This role requires comprehensive knowledge of the US healthcare revenue cycle, including medical billing, medical coding, prior authorization, denial management, and US healthcare insurance verification.
Main Responsibilities:- Team Setup & Leadership:
- Recruit, train, and manage a team of 4+ experienced billers and coders.
- Create SOPs, workflows, and performance metrics from scratch.
- RCM Operations Management:
- Medical Billing & Coding
- Prior Authorizations
- Payer Credentialing
- US Healthcare Insurance Verification
- Charge Entry & Payment Posting
- Denials Management
- Accounts Receivable (AR) Follow-ups
- Ensure HIPAA compliance and process efficiency.
- Performance Monitoring & Quality Assurance:
- Monitor KPIs (AR days, First Pass Resolution Rate, and Denial %).
- Identify and resolve bottlenecks to enhance revenue cycle efficiency.
- Client & Stakeholder Communication:
- Liaise directly with US stakeholders for process updates and escalations.
- Provide regular reports and actionable management insights.
- 10+ years of proven experience in US RCM, with 3+ years in a billing manager/supervisor role.
- Strong expertise in medical billing, medical coding, prior authorization, denial management, and insurance verification.
- Familiarity with ICD-10, CPT/HCPCS, and major PM/EHR systems.
- Proven ability to build and lead high-performing teams.
- Excellent written and verbal communication skills.
- Strong leadership presence and decision-making skills.
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