RCM Payment Entry Specialist

LE9220 Veradigm India Private Limited - Pune; Pune District; On-site; INR 500,000 - 800,000; Full time

Benefits offered by this job

Quarterly Company‑Wide Recharge Days

Peer‑based incentive “Cheer” awards

Tuition Reimbursement Program

Generous benefits package with emphasis on work/life balance

Job summary

LE9220 Veradigm India Private Limited - Pune is seeking a skilled Payment Entry Specialist to handle complex payment posting functions and mentor junior staff. The role focuses on high-dollar remittances, multi-claim EOBs, and improving posting accuracy through quality audits and process efficiencies.

The ideal candidate will have an Associate's degree, relevant experience in healthcare payment posting, and knowledge of billing systems. Benefits include a generous package emphasizing work-life balance and opportunities for professional growth.

Qualifications

• 1–3 years of progressive experience in healthcare payment posting or revenue cycle operations.
• Experience handling complex multi‑payer and high‑dollar remittances.
• Preferable CPC, CRCR, or RHIT certification.

Responsibilities

• Post complex, high‑dollar, and multi‑claim remittances.
• Resolve escalated payment posting discrepancies.
• Conduct quality audits on payment entries processed by team members.

Skills

Advanced knowledge of ERA/EOB interpretation

Mentoring ability

Experience in revenue cycle operations

Proficiency in billing systems

Familiarity with revenue cycle analytics

Education

Associate’s degree in HIM, Healthcare Administration, Accounting, or related field

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 & 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

• 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

• Quarterly Company‑Wide Recharge Days
• Peer‑based incentive “Cheer” awards
• Tuition Reimbursement Program
• Generous benefits package with an emphasis on work/life balance

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