Lead RCM Billing & Coding Specialist

Clustrex Data Private Limited; Chennai District; On-site; INR 1,000,000 - 1,700,000; Full time

Job summary

Clustrex Data Private Limited in Madipakkam, Chennai seeks an experienced Lead RCM Billing & Coding Specialist to own and drive our revenue cycle operations. This role requires hands-on expertise in medical billing, coding, and payer workflows, and the ability to mentor junior team members while ensuring process accuracy and compliance.

You will lead end-to-end RCM activities, review denials, ensure ICD-10, CPT, HCPCS accuracy, monitor AR aging, and coordinate with internal teams on reporting

Qualifications

• 8+ years of experience in US Healthcare RCM.
• Strong hands-on experience in medical billing and coding.
• Familiar with ICD-10, CPT, HCPCS and payer denial management.

Responsibilities

• Lead end-to-end RCM operations including billing, coding, charge entry and claims submission.
• Review denials and underpayments and drive timely collections.
• Mentor junior billing/coding staff and coordinate workflow improvements.
• Ensure compliance with CMS guidelines and HIPAA.

Skills

RCM operations

Medical billing

Medical coding

Payer guidelines

Denial management

Team mentoring

Education

CPC/ CCS cert

Tools

EHRs

Billing systems

Clearinghouses

Job description

Hiring: Lead RCM Billing & Coding Specialist Location: Madipakkam, Chennai Experience: 8+ years Employment Type: Full-time

About the Role

We are looking for an experienced Lead RCM Billing & Coding professional to own and drive our revenue cycle operations. This role is ideal for someone with strong hands-on expertise in medical billing, coding, and payer workflows, who can also guide junior team members and ensure process accuracy and compliance. Note: This role does not require programming or technical development skills.

Key Responsibilities

• Lead end-to-end Revenue Cycle Management (RCM) operations Oversee medical billing, coding, charge entry, and claim submission
• Review and resolve claim rejections, denials, and underpayments
• Ensure accurate application of ICD-10, CPT, HCPCS, and modifiers
• Monitor AR aging , follow up with payers, and drive timely collections
• Ensure compliance with payer rules, CMS guidelines, and HIPAA
• Perform audits on coding and billing to reduce errors and revenue leakage
• Mentor and support junior billing/coding staff
• Coordinate with internal teams on workflow improvements and reporting

Required Qualifications

• 8+ years of experience in US Healthcare RCM
• Strong hands-on experience in medical billing and coding
• Excellent knowledge of: ICD-10, CPT, HCPCS
• Payer guidelines and denial management
• Medicare, Medicaid, and commercial payers
• Experience leading or supervising billing/coding teams
• Strong analytical, communication, and documentation skills
• Ability to work independently and take ownership of outcomes

Preferred Qualifications

• CPC, CCS, or equivalent certification (preferred)
• Experience working with EHRs, billing systems, and clearinghouses
• Exposure to analytics, reporting, or process optimization is a plus

What We Offer

• Opportunity to lead and shape RCM operations
• Collaborative, growth-oriented work environment
• Competitive compensation based on experience
• Long-term career growth and leadership opportunities