RCM Specialist
8 hours ago
Welcome to Veradigm Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.
Veradigm
Welcome to Veradigm Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.
We are an Equal Opportunity Employer. No job applicant or employee shall receive less favorable treatment or be disadvantaged because of their gender, marital or family status, color, race, ethnic origin, religion, disability or age; nor be subject to less favorable treatment or be disadvantaged on any other basis prohibited by applicable law.
For more information, please explore
What will your job look like:
This position has a three-part of Accounts Receivable follow-up, Payment Posting and Charge Entry processing. As such, the position is responsible for the overall recovery and management of the clients' Revenue Cycle. Along with the responsibilities associated with accurately entering charges, posting payments and the subsequent recovery of revenue, the position optimizes all phases of RCM. Additionally, provides training and support to other team members. Supports the RCMS BU's overall Operations and Client Services departments by efficiently and effectively driving the Revenue Cycle Management process and achieving KPI results. No budget responsibilities; must meet established RCM KPI's.
Main Duties:
Strong customer service skills for client satisfaction and client AR health.
- answering client, patient and carrier calls; prompt return and follow up to all interactions; prompt response to requests for information.
- Timely management of unpaid claims as assigned, through the use of the client's office management/administrator.
- Aging reports; correspondence; Clearinghouse and PM rejections; SharePoint reference/maintenance.
- Effectively handles complex payer denials; responsible to ensure that secondary claims are processed and paid.
- Monitoring and reconciliation of claims.
- Timely posting of payments and identifying adjustments and differences in payments.
- Expert ability to input specific data and review patients' issues and credits.
- Knowledgeable of medical EOB's, patient deductibles and co pays, and insurance or third party correspondence.
- Ability to conduct a contract rate audit and provide notification to RCM Management of underpaid or pay equal charges; provide Claim Edit Reports and Unassigned Money Reports as requested.
- Effectively work with clients and others to facilitate information and resolve charge questions.
- Creates credit/debit reports and denial reports in order to provide critical information to the others.
- Expert ability to add specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD codes and date of injury (DOI).
- Understands and interprets the Correct Coding Initiative (CCI) as it applies to charge entry work.
- Timely and efficient entry and reconciliation of batches.
- Processes and conducts discrepancy reconciliation and closing of charge batches across all systems.
- Works with clients and others to facilitate information and resolve charge questions.
- Achieves goal of a 48-hour turnaround batch time.
- Achieves goals set forth by RCM Management regarding error-free work, transactions, processes,
productivity and compliance requirements. Specific goals include 1,400 accounts worked per month.
- Other duties as assigned.
Academic
Qualifications:
- High School Diploma or GED (Required)
An Ideal Candidate will have:
1+ year relevant work experience (Preferred)
- Technical: Extensive knowledge on use of email, search engine, Internet; ability to effectively use payer websites and Laserfiche; knowledge and use of Microsoft Products: Outlook, Word, Excel. Preferred experience with various billing systems, such as NextGen, Pro and Allscripts.
- Personal: Strong written, oral, and interpersonal communication skills; Ability to present ideas in business-friendly and user-friendly language; Highly self-motivated, self-directed, and attentive to detail; team-oriented, collaborative; ability to effectively prioritize and execute tasks in a high-pressure environment.
- Communication: Ability to read, analyze and interpret complex documents. Ability to respond effectively to sensitive inquiries or complaints from employees and clients. Ability to speak clearly and to make effective and persuasive arguments and presentations.
- Math & Reasoning: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to use critical thinking skills to apply principles of logic and analytical thinking to practical problems.
Work Arrangements: Work from Pune Office all 5 days.
Shift Timing: 7:30 PM IST to 4:30 AM IST (US Shift)
Benefits
Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish.
- Quarterly Company-Wide Recharge Days
- Peer-based incentive "Cheer" awards
- "All in to Win" bonus Program
- Tuition Reimbursement Program
To know more about the benefits and culture at Veradigm, please visit the links mentioned below: -
Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.
Thank you for reviewing this opportunity Does this look like a great match for your skill set? If so, please scroll down and tell us more about yourself
-
Director - Training (RCM)
10 hours ago
Pune, Maharashtra, India Credence Resource Management Full time ₹ 12,00,000 - ₹ 36,00,000 per yearJob Role & ResponsibilitiesTraining Strategy and Leadership:Develop and implement a company-wide training and development strategy aligned with business objectives, client needs, and industry best practices.Oversee the design, delivery, and continuous improvement of training programs for new hires, existing employees, and leadership teams in the RCM BPO...
-
RCM Charge Entry Specialist
6 days ago
Pune, Maharashtra, India Veradigm® Full time ₹ 2,00,000 - ₹ 6,00,000 per yearWelcome to Veradigm Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an...
-
RCM Payment Entry Specialist
10 hours ago
Pune, Maharashtra, India Veradigm® Full time ₹ 6,00,000 - ₹ 12,00,000 per yearWelcome to Veradigm Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an...
-
Assistant Vice President Training
2 days ago
Pune, Maharashtra, India Glorious Hr Services Full time ₹ 24,00,000 - ₹ 36,00,000 per yearRole: Associate Vice President (AVP) Training | US Healthcare RCMLocation: Pune (Work from Office)Shift Timing: US ShiftsCTC: Up to 20 LPAWe are hiring for the role of AVP Training to lead learning & development initiatives and strengthen training functions within the US Healthcare RCM domain.Required Experience:Minimum 14 years of overall experience in US...
-
Success Factors
1 week ago
Pune, Maharashtra, India Shree Consultancy Services Full time ₹ 25,00,000 - ₹ 35,00,000 per yearJob DescriptionClient OverviewOur client is one of the largest Global Indian Corporate Groups in the manufacturing of rotating equipment and machinery, with an annual turnover of over ₹4,000 Cr. Headquartered at their Global Corporate Office in Wakad/Baner, Pune (Pune–Bangalore Highway), the company delivers complete fluid management solutions for large...
-
HR Systems Specialist
7 days ago
Pune, Maharashtra, India GKN Aerospace Careers Full time ₹ 5,00,000 - ₹ 12,00,000 per yearFantastic challenges. Amazing opportunities.GKN Aerospace is reimagining air travel: going further, faster and greener Fuelled by great people whose expertise and creativity sets the standards in our industry, we're inspired by the opportunities to innovate and break boundaries. We're proud to play a part in protecting the world's democracies. And we're...
-
SAP Specialist
4 weeks ago
Pune, Maharashtra, India Birlasoft Full timeAbout Us:Birlasoft, a global leader at the forefront of Cloud, AI, and Digital technologies, seamlessly blends domain expertise with enterprise solutions. The company's consultative and design-thinking approach empowers societies worldwide, enhancing the efficiency and productivity of businesses. As part of the multibillion-dollar diversified CKA Birla...
-
Analyst - OTC Global
2 days ago
Pune, Maharashtra, India UPL Full time ₹ 9,00,000 - ₹ 12,00,000 per yearPosition : Executive/Analyst/Specialist- OTC Global & India OperationsReports to : OTC LeadGrade / GJL : 1A/1B/2ª/2BDate : Aug 2025Position IDReplacement / New : NewReasonResponsibilitiesCash ApplicationEfficiently process daily cash receipts, including Cheque payments, ACH payments and on account payments.Research and resolve unidentified &Unapplied...
-
SAP Specialist
4 weeks ago
Pune, Maharashtra, India Birlasoft Full timeAbout Us: Birlasoft, a global leader at the forefront of Cloud, AI, and Digital technologies, seamlessly blends domain expertise with enterprise solutions. The company's consultative and design-thinking approach empowers societies worldwide, enhancing the efficiency and productivity of businesses. As part of the multibillion-dollar diversified CKA Birla...
-
SAP Specialist
4 weeks ago
Pune, Maharashtra, India Birlasoft Full timeAbout Us: Birlasoft, a global leader at the forefront of Cloud, AI, and Digital technologies, seamlessly blends domain expertise with enterprise solutions. The company's consultative and design-thinking approach empowers societies worldwide, enhancing the efficiency and productivity of businesses. As part of the multibillion-dollar diversified CKA Birla...