Job Title
RCM Process Executive (Revenue Cycle Management)
Job Summary
The RCM Process Executive is responsible for managing the healthcare revenue cycle by ensuring accurate medical billing, claims submission, payment posting, denial management, and accounts receivable follow-up. The role focuses on maximizing reimbursements while maintaining compliance with healthcare regulations.
Key Responsibilities
Verify patient insurance eligibility and benefits.
Process medical claims accurately and submit them to insurance companies.
Follow up on unpaid, denied, or rejected claims.
Post payments and reconcile accounts.
Resolve billing discrepancies and insurance issues.
Communicate with insurance companies and healthcare providers regarding claim status.
Maintain accurate documentation of all billing activities.
Ensure compliance with HIPAA and payer guidelines.
Meet productivity and quality targets.
Required Skills
Knowledge of the Revenue Cycle Management process.
Understanding of medical billing, coding (ICD-10, CPT, HCPCS), and insurance terminology.
Strong analytical and problem-solving skills.
Good communication and interpersonal skills.
Attention to detail and accuracy.
Proficiency in MS Excel and healthcare billing software.
Qualifications
Bachelor's degree (preferred, but requirements vary by employer).
Certification in medical billing/coding is an advantage.
Freshers or candidates with 0–3 years of experience in healthcare BPO/RCM can apply.
Common RCM Process Areas
Patient Registration
Insurance Verification
Charge Entry
Medical Coding
Claims Submission
Payment Posting
Denial Management
Accounts Receivable (AR) Follow-up
Medical Billing
This JD can be adapted for freshers, AR Callers, Medical Billers, Charge Entry Executives, or Denial Management Specialists, depending on the specific RCM role.
Pay: ₹16,000.00 - ₹28,000.00 per month
Benefits:
- Paid sick time
- Provident Fund
Work Location: In person
