Greetings!!!
We are hiring for Revenue cycle specialist(US Health care)
Job Description:
Exp:5+ Years (US health care)
Qualification: Any Graduate
Location :Nallagandla,Hyd
Shift: 1 PM -9 PM
5 Days working
Male or Female
Note: Looking for immediate to 15 days joiners
Roles and Responsibilities:
· Manage End-to-End Revenue Cycles: Execute comprehensive RCM workflows for US-based Durable Medical Equipment (DME) providers, ensuring financial integrity from claim submission to final payment.
· Platform Mastery: Utilize Brightree as the primary system of record to manage patient accounts, process claims, and maintain real-time data accuracy.
· Precision Cash Posting: Perform high-volume posting of insurance and patient payments (ERAs and manual EOBs) with a focus on reconciling bank deposits to system entries.
· Strategic AR Management: Conduct rigorous follow-up on outstanding claims, identifying aging trends and prioritizing high-dollar accounts to minimize Days Sales Outstanding (DSO).
· Denial Resolution & Analysis: Investigate claim rejections and denials; perform root-cause analysis to implement corrective actions and resubmit clean claims for reimbursement.
· Process Automation: Leverage AI-driven tools and Brightree’s advanced features to automate repetitive billing tasks and enhance the speed of the revenue cycle.
· Payer Compliance: Stay current on Medicare, Medicaid, and commercial insurance guidelines (HCPCS, modifiers, and documentation requirements) to ensure 100% compliance.
· Cross-Border Collaboration: Partner closely with US-based clinical teams and client stakeholders via virtual meetings to resolve documentation gaps and refine billing assumptions.
· Reporting & Insights: Generate and present clear, client-ready reports on key performance indicators (KPIs), providing actionable insights into the client’s financial health.
· Operational Excellence: Identify opportunities to streamline RCM processes while bridging cultural and operational nuances between the India-based delivery center and US-based providers.
Key Competencies and Qualifications:
· 3+ years of experience in a US Healthcare RCM role, specifically focused on Durable Medical Equipment (DME) or Home Medical Equipment (HME).
· Advanced proficiency in Brightree (software) is mandatory
· Strong understanding of DME-specific billing requirements, including CMNs (Certificates of Medical Necessity), Prior Authorizations, and US GAAP principles related to healthcare.
· Exceptional attention to detail with the ability to navigate complex payer portals and interpret intricate Explanation of Benefits (EOB) statements.
· Proficient in Microsoft Excel (VLOOKUPs, Pivot Tables) and experience leveraging AI tools (e.g., ChatGPT, Copilot, Gemini) to optimize workflow efficiency.
· Communication Skills: Excellent verbal and written English, with the ability to clearly explain denial reasons and financial discrepancies to US-based stakeholders.
· Reliability & Agility: Process-oriented and adept at managing high volumes of data while successfully adapting to Eastern Standard Time (EST) shift requirements.
· Cultural Competence: Thrives in a collaborative, cross-cultural environment and is comfortable using remote collaboration tools like Google Meet, Slack, and Monday.com.
· Eager to grow with Our with a desire for long-term professional advancement.
Pay: ₹500,000.00 - ₹900,000.00 per year
Benefits:
Work Location: In person
