Senior Process Associate RCM

7 days ago

Hyderabad, Telangana, India Arya Medical Billing Services Full time ₹ 12,00,000 - ₹ 36,00,000 per year

Job Title: Senior Process Associate RCM (US Healthcare)

Department: Revenue Cycle Management (RCM)

Location: Gachibowli,Hyderabad

Experience: 47 years in US Healthcare RCM

Reports To: Team Lead / Manager RCM

Job Summary:

The Senior Process Associate is responsible for overseeing end-to-end medical billing activities within the US healthcare RCM process. This role involves handling complex billing scenarios, ensuring accurate charge entry, payment posting, denial management, and account follow-up while mentoring junior team members and supporting process improvements to maximize revenue realization and reduce AR days.

Key Responsibilities:

  • Review and process medical claims for submission to insurance carriers (primary, secondary, tertiary).
  • Ensure accurate charge entry, payment posting, and adjustments in compliance with payer rules and regulations.
  • Perform denial analysis and reprocessing, identifying root causes to prevent recurrence.
  • Handle Accounts Receivable (AR) follow-up on pending and denied claims to ensure timely reimbursement.
  • Verify patient demographics, insurance eligibility, and benefits before billing.
  • Coordinate with payers, providers, and internal teams to resolve billing discrepancies.
  • Prepare and analyze aging reports, identifying trends and recommending corrective actions.
  • Maintain compliance with HIPAA and company policies regarding data security and patient confidentiality.
  • Mentor junior billing staff and provide process training as needed.
  • Participate in quality audits, process improvement initiatives, and system updates.

Key Skills & Competencies:

  • In-depth knowledge of US healthcare RCM process (Charge Entry, Payment Posting, AR, Denials, etc.)
  • Strong understanding of CPT, ICD-10, HCPCS codes, and payer-specific billing guidelines.
  • Experience working on EHR/PM systems (e.g., Athena, Kareo, eClinicalWorks, AdvancedMD, etc.)
  • Proficient in MS Excel and reporting tools.
  • Excellent analytical, problem-solving, and communication skills.
  • Ability to work independently with minimal supervision and handle high-volume billing efficiently.

Qualifications:

  • Bachelors degree in any discipline (preferably Life Sciences, Commerce, or Healthcare Management).
  • Minimum 4 years of experience in US Healthcare Medical Billing / RCM process.
  • Certification in Medical Billing and Coding (CPC, CMRS, etc.) is a plus.

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