Healthcare Revenue Cycle Management Specialist

Virtualbinz; Udaipur District; On-site; INR 500,000 - 800,000; Full time

Job summary

Virtualbinz seeks a detail-oriented RCM professional to manage end-to-end healthcare revenue cycle operations. You will ensure accurate billing, minimize claim denials, and support timely revenue realization. Strong knowledge of insurance processes, claims management, and practice management software is essential.

Responsibilities include verification, eligibility checks, denials analysis, AR management, and close coordination with payers to resolve issues and ensure timely account closure.

Qualifications

• Experience with end-to-end RCM processes in healthcare.
• Familiarity with payer guidelines and eligibility verification.
• Proficiency in practice management software and electronic health records.

Responsibilities

• Manage complete RCM workflow from scheduling to patient follow-ups.
• Verify insurance eligibility, benefits, and pre-determinations.
• Process claims, manage denials, AR, and reconciliations.
• Coordinate with payers/clients for timely resolutions.
• Identify denial trends and support resubmissions and appeals.
• Maintain detailed documentation and ensure payer compliance.

Skills

RCM

Healthcare billing

Claims management

Denials analysis

AR management

Payer communication

Documentation

Process improvement

Tools

Practice management software

Job description

We are seeking a detail-oriented and proactive RCMprofessional to manage end-to-end healthcare revenue cycle operations, ensureaccurate billing, minimize claim denials, and support timely revenuerealization. The ideal candidate should have strong knowledge of insuranceprocesses, claims management, and healthcare practice management software.

Requirements

Key Responsibilities

• Managethe complete RCM workflow, including patient scheduling, insuranceeligibility and benefits verification, pre-determinations (Pre-Ds), claimsprocessing, payments, ERAs, denials, accounts receivable (AR),reconciliation, and patient follow-ups.
  
• Reviewpayer guidelines, coverage history, service frequencies, benefitlimitations, out-of-network (OON) benefits, and documentation to identifypotential billing issues.
  
• Monitorappointments, claims, outstanding balances, payments, denials, andfollow-ups while maintaining accurate records and resolving discrepanciesacross systems.
  
• Investigatecomplex account issues and coordinate with payers and clients to ensuretimely resolution from initial verification to final account closure.
  
• Identifyclaim rejection and denial trends, follow up on unpaid or underpaidclaims, and support timely resubmissions and appeals to minimize revenueloss.
  
• Maintaindetailed account documentation, ensure compliance with payer requirements,and recommend process improvements to enhance billing accuracy andoperational efficiency.
  

Required Software Knowledge

Hands-on experience with one or more of the followingplatforms: