Billing Specialist / Billing Manager – U.S. Healthcare RCM
Responsibilities
- Prepare and submit accurate, timely claims for U.S. healthcare clients across multiple payer types
- Manage Medicare billing through EMR integrated with a clearinghouse, Medicare billing through DDE/FISS, Managed Medicare (MA)/Commercial/Medicaid claims by exporting claim files to the clearing house
- Perform pre-bill audits to ensure claims comply with Medicare, Medicaid, and payer guidelines
- Verify patient eligibility, benefits, authorizations, and coverage requirements
- Post ERAs/EOBs, reconcile 835 payments, and process adjustments or refunds
- Manage claim rejections and denials end-to-end (reason codes, corrections, resubmissions, appeals, ADRs)
- Conduct A/R follow-up with U.S. payors to resolve unpaid or underpaid claims
- Track and help improve key billing metrics including DSO, clean claim rate, and denial rate
Must-Have Experience [don't apply if you don't have the below]
- Excellent verbal communication skills (10/10) with the ability to confidently call and communicate with U.S. payors
- Proven experience performing billing and collections for U.S. healthcare providers
- Hands-on experience with claims submission, payment posting, denial management, and A/R follow-up
- Experience working in U.S. healthcare Revenue Cycle Management (RCM) for provider organizations
- Prior experience supporting U.S.-based healthcare clients or working in a healthcare BPO environment
Nice to Have / Differentiators
- Home health billing experience, particularly under PDGM
- Experience working with WellSky/Kinnser EMR
- Experience with Waystar, Office Ally, or other U.S. healthcare clearinghouses
Additional Preference
- Immediate joiners are preferred, or candidates with a notice period of 30 days or less.
Why Join Us?
- Opportunity to build and lead a high‑impact RCM and operations organization in a fast‑growing healthtech company.
- P&L ownership and strategic involvement in shaping Hoolime’s U.S. healthcare business.
- Exposure to modern tools, data‑driven operations, and cross‑functional collaboration across product, technology, and analytics.
- Competitive compensation and benefits package.
Pay: ₹500,000.00 - ₹1,200,000.00 per year
Benefits:
Work Location: In person
