RCM Specialist

5 days ago


Navi Mumbai, Maharashtra, India Whitefield Careers Private Limited Full time

Key Responsibilities

  • Provide Level 1 and Level 2 support for RCM workflows, including claim

submission, charge entry, payment posting, and denial management.

  • Troubleshoot payer rejections, configuration errors, and ERA posting

discrepancies.

  • Analyze EDI 835/837 transaction data to identify and resolve logic or

mapping issues.

  • Collaborate with clearinghouses (Waystar, Availity, Change Healthcare) to

address payer-related discrepancies.

  • Document recurring issues, perform root cause analysis, and work with

internal teams to prevent recurrence.

  • Communicate effectively with U.S. clients, ensuring clear, solution-oriented

updates and documentation.

  • Maintain compliance with HIPAA and 42 CFR Part 2 guidelines while

handling sensitive data.

Required Skills s Domain Expertise

  • Strong understanding of U.S. Healthcare RCM including charge entry,

payment posting, denial analysis, and AR follow-up.

  • In-depth knowledge of payer rules (Medicare, Medicaid, commercial

payers).

  • Working knowledge of CPT, ICD-10, HCPCS, modifiers, and ERA/EDI 835-

837 transactions.

  • Demonstrated ability to identify root causes behind denials and system-level

billing issues.

Technical Competencies

  • Hands-on experience with one or more medical billing systems:

Collaborate MD, Kareo, AdvancedMD, Athenahealth, eClinicalWorks,

DrChrono, NextGen, PracticeSuite, or similar.

  • Experience using clearinghouse portals such as Waystar, Availity, and

Change Healthcare.

  • Familiarity with ticketing tools like Zendesk, Freshdesk, or Salesforce

Service Cloud.

  • Strong Excel skills for reporting, validation, and analysis (pivot tables,

lookups).

Customer Support Competencies

  • Analytical thinker who investigates workflow issues instead of surface-level

resolutions.

  • Excellent written and verbal communication skills tailored for non-technical

audiences.

  • Ability to collaborate with internal product or development teams for

technical fixes and process improvements.

  • Proven record of maintaining high CSAT scores and quick response times.

Qualifications

  • Bachelor's Degree (preferably in Commerce, Healthcare Administration, or

related field).

  • 3–6 years of relevant experience in U.S. Healthcare RCM.

  • Certifications preferred: HIPAA Awareness, AAPC CPC (in progress or

completed).

Job Type: Full-time

Pay: ₹50, ₹65,000.00 per month

Application Question(s):

  • What is your current CTC?
  • What is your expected CTC?
  • What is your notice period?
  • Are you comfortable with rotational shifts and rotational weekoff(Including Night shifts)?
  • Are you comfortable with face to face interview in navi mumbai?

Experience:

  • US Healthcare RCM: 3 years (Preferred)


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