RCM Charge Entry Specialist - MBC

LE9220 Veradigm India Private Limited - Pune; Pune District; On-site; INR 300,000 - 540,000; Full time

Benefits offered by this job

Recharge days

Cheer awards

Tuition reimbursement

Job summary

LE9220 Veradigm India Private Limited - Pune is seeking a detail-oriented professional to manage charge entry from client data, ensuring accurate demographics and charges for patient information and insurance. The role supports RCMS Operations and Client Services by driving accounts receivable processes and KPI attainment.

The candidate will review modifiers, CPT/ICD codes, and payer requirements, aiming to reduce denials and ensure timely batch closure across systems, while maintaining policy

Qualifications

• Experience with accounts receivable processes.
• Ability to review source data and input demographics and charges accurately.
• Knowledge of modifiers, payer information, and authorization criteria.
• Understanding of Correct Coding Initiative (CCI).

Responsibilities

• Handle charge entry with accurate demographic and charge data.
• Answer client calls and follow up promptly.
• Process and reconcile charge batches across systems.
• Reduce denials by correct use of modifiers and codes.
• Meet 48-hour batch turnaround target.
• Prepare Claim Edit Reports and Unassigned Money Reports.
• Ensure compliance with policies and procedures.

Skills

Customer service

Call handling

Data entry

CPT ICD knowledge

Job description

JOB SUMMARY

Responsible for charge entry through the careful review of source data provided by clients with accurate recording demographics and charges associated with patient information and insurance. Supports the RCMS BU's overall Operations and Client Services by efficiently and effectively driving the accounts receivable process and achieving KPI results.

ESSENTIAL FUNCTIONS/MAJOR JOB RESPONSIBILITIES:

• Strong customer service skills
• answering client calls
• prompt return and follow up to all interactions
• prompt response to requests for information, both internally and externally Timely input of demographic charges and time of service payment information
• Expert ability to add specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD codes and date of injury (DOI)
• Knowledgeable to append modifiers based on payer specifics, insurance and authorization requirements and referring physicians’ unique attributes
• Understand and interpret the Correct Coding Initiative (CCI) as it applies to charge entry work
• Reduce denials by correct use of modifiers, mapping, and linking codes with services
• Responsible for the processing and discrepancy reconciliation and closing of charge batches across all systems
• Successfully and effectively track and follow up on information requests to and from the clients.
• Work with clients and others to facilitate information and resolve charge questions
• Achieve goal of a 48-hour turnaround batch time
• Responsible for Claim Edit Reports and Unassigned Money Reports
• Complies and enforces all policies and procedures
• Achieve goals set forth by RCM Management regarding error-free work, transactions, processes, productivity and compliance requirements

Benefits

• Quarterly Company-Wide Recharge Days
• Peer-based incentive “Cheer” awards
• Tuition Reimbursement Program

To know more about the benefits and culture at Veradigm, please visit the links mentioned below: https://veradigm.com/about-veradigm/careers/benefits/ https://veradigm.com/about-veradigm/careers/culture/

Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

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Welcome to Veradigm, where our Mission is transforming health, insightfully.

Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve.

At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders.

Together, we can transform healthcare and enable smarter care for millions of people.