Medical Billing

14 hours ago

Ahmedabad, Gujarat, India Account Prism Full time ₹ 8,00,000 - ₹ 18,00,000 per year

Medical Billing (RCM) Team Lead

Location: Thaltej, Ahmedabad

Experience: 4 to 7 years in U.S. Healthcare RCM (with team handling experience)

Employment Type: Full-time | Work From Office

About the company: Account Prism, founded in 2013, is a women-owned business transformation firm with a team of seasoned professionals who have 15+ years of experience across various domains in the US. Our service line includes Accounting, Tax, RCM and technology services.

About the Role

We are hiring an experienced RCM Team Lead who can oversee end-to-end revenue cycle management processes, mentor a team, and drive performance to achieve billing and collection targets. The role requires expertise in AR, denials, credentialing, ERA/EFT enrolments, and client coordination, along with strong leadership qualities.

Key Roles & Responsibilities

Team Leadership & Operations

Lead and supervise the medical billing/AR team, ensuring productivity and accuracy.

Allocate tasks based on team strengths and monitor day-to-day performance.

Train and mentor new joiners; prepare SOPs and process documentation.

Conduct regular performance evaluations and provide constructive feedback.

Manage a team of 6-10 people in our RCM department.

RCM Process Management

Oversee charge posting, payment posting, AR follow-up, and denial management.

Handle escalated claims and complex billing/payment issues.

Optimize accounts receivable processes to reduce denials and improve collections.

Conduct root cause analysis for underpayments and rejections; implement corrective actions.

Client & Compliance Management

Coordinate with U.S. clients (physician offices) for query resolution.

Conduct weekly/monthly review meetings with clients and internal stakeholders.

Manage credentialing/re-credentialing with payers across different states.

Ensure compliance with HIPAA and payer billing guidelines.

Reporting & Analysis

Generate and analyze AR aging, collection rate, and cash flow reports.

Track KPIs such as DAR (Days in AR), denial rates, and collection percentages.

Present regular updates and improvement strategies to senior management.

Requirements

Graduate (Commerce/ Science preferred)

4 to 7 years of U.S. Healthcare RCM experience, including team leadership.

Strong knowledge of ICD-9, ICD-10, CPT, HCPCS, HIPAA compliance.

Experience in ERA/EFT enrolment, payer credentialing, and CAQH/NPPES.

Hands-on expertise in billing software/EMR systems and MS Excel.

Excellent communication, client handling, and leadership skills.

Perks & Benefits

Competitive salary with performance-based incentives.

5-day working.

Career growth into managerial roles.

Continuous training and learning opportunities

Everyday Snacks and Dinner

Events and fun Fridays.

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