About the Role
We are looking for a detail-oriented and results-driven RCM Executive to join our Revenue Cycle Management team. The role will be responsible for managing and following up on healthcare claims, identifying outstanding accounts, resolving denials, and ensuring timely reimbursement from insurance companies.
The candidate should have a good understanding of the US Healthcare RCM process, strong communication skills, and the ability to work effectively in a target-driven environment.
Key Responsibilities
- Manage accounts receivable and ensure timely follow-up on outstanding healthcare claims.
- Perform AR calling with insurance companies to check claim status, payment status, denials, and pending claims.
- Investigate and resolve claim denials, rejections, underpayments, and other billing issues.
- Review EOBs/ERAs and identify discrepancies in payments and adjustments.
- Coordinate with insurance companies and internal teams to resolve claim-related issues.
- Ensure accurate and timely documentation of follow-up activities in the relevant systems.
- Identify trends in denials and outstanding claims and escalate recurring issues to the team concerned.
- Follow up on unpaid, partially paid, or incorrectly processed claims within the defined timelines.
- Maintain productivity and quality standards as per team and process requirements.
- Meet daily/weekly/monthly targets related to AR calling, claim follow-ups, collections, and resolution.
- Ensure compliance with established processes and data confidentiality requirements.
- Collaborate with billing, coding, and other RCM teams to resolve issues and improve collections.
Requirements
- Bachelor's degree in any discipline.
- 2-5 years of experience in US Healthcare RCM, preferably in AR calling, denial management, or medical billing.
- Good understanding of the US healthcare revenue cycle and insurance processes.
- Experience handling insurance calls and claim follow-ups.
- Knowledge of claim denials, rejections, EOB/ERA, and payment posting is preferred.
- Strong verbal and written communication skills.
- Good analytical and problem-solving abilities.
- Comfortable working with targets and handling a high volume of accounts.
- Good working knowledge of MS Office and basic computer applications.
Preferred Skills
- AR Calling
- Denial Management
- Claims Follow-up
- Medical Billing
- Insurance Verification
- EOB/ERA Analysis
- US Healthcare RCM
- Excellent Communication
- Problem Solving
- Attention to Detail
Shift - US Night Shift
Employment Type - Full-time
Location - Remote / Work from Home
Benefits:
- Health insurance
- Life insurance
- Paid time off
- Provident Fund
- Work from home
Work Location: Remote
