Looking for Senior process analyst with minimum 5 years experience and Strong understanding of End to End RCM processes such as Demo, charges, Eligibility verification, billing, payment posting, denials management, appeals process, AR review and insurance follow-up.
Position Summary
As a Process Analyst / Senior Process Analyst - RCM , you will be involved in the full lifecycle of Revenue Cycle Management, encompassing front-end, mid-cycle, and back-end operations. You will analyze existing workflows, identify bottlenecks, and implement process improvements to enhance revenue capture and reduce denials. The Senior role requires managing complex, end-to-end projects with minimal supervision and mentoring junior analysts.
Built In Chennai
Key Responsibilities & Scope
- End-to-End RCM Process Expertise: Analyze and optimize workflows across Patient Access (Eligibility/Authorization), Medical Billing, Charge Capture, Claims Submission, Payment Posting, and Denial Management/AR.
- Denial Management & AR Reduction: Review, audit, and analyze denied/rejected insurance claims to identify root causes and implement corrective strategies.
- Data Analysis & Reporting: Develop, maintain, and analyze reports and dashboards to track KPIs like AR days, denial rates, and clean claim rates.
- Process Improvement & Documentation: Create and update Standard Operating Procedures (SOPs), flowcharts, and job aids to improve efficiency.
- System & Payer Knowledge: Leverage knowledge of payer portals (Medicare, Medicaid, Commercial) and EHR/billing systems (Epic, Cerner, Athena, eClinicalWorks).
- Compliance: Ensure strict adherence to HIPAA, NCCI edits, and CMS compliance guidelines.
Required Qualifications
o Senior Process Analyst: 3–6+ years of relevant experience, with at least 2 years in a senior or specialized RCM role.
- Education: Bachelor’s degree in Commerce, Computer Applications, Healthcare Administration, or related field.
o Proficiency in Microsoft Office Suite (Excel, basic formulas, word, PPT)
o Familiarity with EHR/RCM systems (Epic, Cerner, eCW etc.).
- Domain Expertise: Strong understanding of End to End RCM processes such as Demo, charges, Eligibility verification, billing, payment posting, denials management, appeals process, AR review and insurance follow-up.
Key Skills & Competencies
- Excellent analytical and problem-solving skills.
- Strong verbal and written communication skills (neutral accent preferred for voice-related roles).
- Ability to work in a high-pressure, fast-paced environment and meet daily productivity targets.
- Ability to adapt quickly to new and changing technical environments.
getwork.org
