RCM Payment Entry Specialist

Veradigm Inc.; Pune District; On-site; INR 400,000 - 700,000; Full time

Benefits offered by this job

Quarterly Company-Wide Recharge Days

Peer-based incentive “Cheer” awards

Tuition Reimbursement Program

Job summary

Veradigm Inc. is seeking a Payment Entry Specialist in Pune to handle advanced payment posting, including high-dollar remittances and multi-claim EOBs. You will mentor junior staff, lead quality audits, and drive process improvements to ensure accuracy and timely postings.

The role requires 1–3 years in healthcare payment posting, strong ERA/EOB skills, and knowledge of payer contracts. Compliance with HIPAA and CMS policies is essential, with opportunities to impact monthly close and

Qualifications

• Associate's degree in HIM, Healthcare Administration, Accounting, or related field; Bachelor's.
• 1-3 years of progressive experience in healthcare payment posting or revenue cycle operations.
• Advanced knowledge of ERA/EOB interpretation, CARC/RARC codes, coordination of benefits, and payer contract terms.

Responsibilities

• Post complex, high-dollar, multi-claim remittances with COB, capitation, and bundled payments.
• Resolve escalated payment posting discrepancies, including misapplied payments.
• Perform secondary and tertiary posting with balance transfer and patient responsibility calculation.
• Conduct quality audits on payment entries and coach junior staff on posting workflows.
• Mentor and train junior payment entry staff on posting workflows and reconciliation procedures.
• Analyze posting error trends and unapplied cash aging; prepare reports for leadership.
• Manage month-end and quarter-end reconciliation close activities.
• Serve as escalation point for payer recoupment disputes, offset resolution, and complex refund scenarios.
• Maintain and update payment posting SOPs, payer-specific posting guides, and quick-reference materials.
• Support system testing for billing platform upgrades and ERA/835 integration changes.
• Ensure compliance with HIPAA, CMS, and organizational financial policies.

Skills

ERA/EOB interpretation

Coordination of benefits

Payer contract terms

Mentoring

Education

Associate's degree

Bachelor's degree

Tools

Billing systems

Clearinghouse platforms

Job description

Position Summary

The Payment Entry Specialist handles advanced and complex payment posting functions including high-dollar remittances, multi-claim EOBs, complex coordination of benefits payments, and escalated reconciliation variances. This role serves as the technical expert within the payment posting team, mentoring junior staff, leading quality audits, and driving process efficiencies to improve posting accuracy and turnaround.

Essential Duties and Responsibilities

Post complex, high-dollar, and multi-claim remittances requiring advanced knowledge of coordination of benefits, capitation payments, and bundled payment arrangements. Resolve escalated payment posting discrepancies, including misapplied payments, unidentified cash, and complex take-back scenarios. Perform secondary and tertiary payment posting with proper balance transfer and patient responsibility calculation. Conduct quality audits on payment entries processed by team members, identifying patterns and providing corrective coaching. Mentor and train junior payment entry staff on posting workflows, payer contract interpretation, and reconciliation procedures. Analyze posting error trends and unapplied cash aging, preparing reports and recommending corrective actions to leadership. Manage month-end and quarter-end reconciliation close activities, ensuring all outstanding items are resolved. Serve as escalation point for payer recoupment disputes, offset resolution, and complex refund scenarios. Maintain and update payment posting SOPs, payer-specific posting guides, and quick-reference materials. Support system testing for billing platform upgrades and ERA/835 integration changes. Ensure compliance with HIPAA, CMS, and organizational financial policies.

Qualifications

Required Associate's degree in HIM, Healthcare Administration, Accounting, or related field; Bachelor's. 1-3 years of progressive experience in healthcare payment posting or revenue cycle operations. Advanced knowledge of ERA/EOB interpretation, CARC/RARC codes, coordination of benefits, and payer contract terms. Experience handling complex multi-payer and high-dollar remittances. Proficiency in billing systems and clearinghouse platforms. Demonstrated mentoring ability and quality improvement experience. Preferable CPC, CRCR, or RHIT certification. Experience with capitation, bundled payments, and value-based reimbursement posting. Familiarity with revenue cycle analytics and KPI dashboard reporting. Prior experience in hospital-based or multi-specialty payment environments.

Benefits

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish. 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/

#LI-SL1 Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce. Thank you for reviewing this opportunity! 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, health care providers, 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 health and enable smarter care for millions of people.