Experienced RCM Specialist

3 days ago

Palakkad, Kerala, India beBeeMedicalBilling Full time ₹ 40,00,000 - ₹ 50,00,000
Job Description

My company is a leading laboratory specializing in wellness and toxicology testing, committed to providing accurate and timely results to support healthcare decisions.

We are currently seeking a skilled and detail-oriented Medical Billing Specialist to join our team and contribute to efficient revenue cycle management.

As a Medical Billing Specialist, you will play a crucial role in managing the billing processes to ensure timely and accurate submission of claims, efficient processing of payments, and adherence to industry regulations.

Responsibilities:

  • Oversee the accurate and timely processing of claims, ensuring compliance with payer guidelines and regulations.
  • Review and address billing discrepancies, rejections, and denials, implementing corrective actions as needed.
  • Develop and implement billing policies and procedures to improve accuracy and efficiency.
  • Collaborate with coding, compliance, and other departments to ensure accurate coding and documentation.
  • Analyze billing data and metrics to identify trends, issues, and opportunities for process improvements.
  • Ensure proper follow-up on unpaid or denied claims and manage the appeals process.
  • Oversee the use of billing software and electronic health record (EHR) systems, ensuring they are up-to-date and functioning properly.
  • Stay informed about changes in U.S. revenue cycle management practices and federal regulations to ensure billing processes remain compliant and optimized.
  • Provide guidance and training to the billing team on evolving industry standards and policy updates.
Required Skills and Qualifications

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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