Business Analyst

5 days ago

Cochin, Kerala, India Zentact Systems Full time

Position : BA/PO with specialist RCM knowledge

We are seeking a highly skilled and detail-oriented BA with specialist RCM knowledge to help in detailing requirements for end-to-end revenue cycle operations. The ideal candidate will have hands-on experience across front-end, mid-cycle, and back-end RCM processes, with a strong understanding of payer requirements, coding standards, and claims workflows. Here is some more details.

Key Responsibilities:
The candidate should be experienced in the areas shown below and have experienced in creating detailed requirements.

Front-End RCM

  • Patient registration and intake with accuracy
  • Insurance eligibility and benefits verification
  • Prior authorization processes and coverage validation
  • Documentation of medical necessity and payer requirements

Mid-Cycle RCM

  • CPT, ICD-10, HCPCS, J-Codes, and SNOMED
  • Specifics for submission of 837P and 837I
  • Understand payer-specific rules and clean claim submission
  • Denials and resubmissions with appropriate documentation

Back-End RCM

  • Posting payments and Reconciliation of claims using ERA and EOBs
  • Analysis of payment variances and resolution of discrepancies
  • Management of patient balances and coordination of billing follow-ups
  • Resolution process with finance and customer service teams

Work Location : TVM/Kochi/ Hyderabad, Bangalore, Chennai.

Interested applicants- Please send us latest resume in word format

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