Revenue Cycle Representative

Talent21 Management and Shared Services Pvt Ltd; Chennai; On-site; INR 420,000 - 620,000; Full time

Job summary

Talent21 Management and Shared Services Pvt Ltd is seeking a Revenue Cycle Representative specialized in Hospital Billing (HB) to manage hospital and facility claims, ensure accurate billing workflows, and uphold compliance across institutional financial processes.

You will collaborate with coding, billing, and patient access teams, monitor aging reports, and work to minimize A/R days while ensuring timely filing and payer communications.

Qualifications

• Proven experience in healthcare Hospital Billing (RCM) with a focus on institutional facility claims and a strong understanding of UB-04 (CMS-1450).
• Strong knowledge of hospital insurance guidelines, institutional payer policies, facility reimbursement methodologies, and medical terminology
• Good reading, writing, and analytical skills paired with strong communication to collaborate effectively with colleagues and supervisors.
• Fast and accurate keyboard/typing skills for high-volume data entry into complex Hospital Information Systems (HIS) and EHR platforms.

Responsibilities

• 1. Claim Management Follow-up.
• 2. Denial Management
• 3. Strong understanding of Hospital billing processes
• 4. Proficiency in medical billing software & Electronic Health Records (EHR).
• 5. Medicare DDE is added advantage
• 6. Review aging reports and prioritize accounts for follow-up based on outstanding balances and timely filing limits.
• 7. Follow up with insurance payers (Medicare, Medicaid, Commercial, etc.) via calls or portals to check claim status.
• 8. Analyze denied or underpaid claims, identify root causes, and take corrective actions such as appeals or rebilling.
• 9. Collaborate with coding, billing, and patient access teams to resolve discrepancies and update account information.
• 10. Document all follow-up actions and maintain accurate notes in the billing system (e.g., Epic, Cerner, Athena, etc.)
• 11. Work to reduce A/R days and improve cash collections through proactive resolution strategies.
• 12. Escalate unresolved issues to Team Lead or Management for intervention.
• 13. Understand payer-specific guidelines, denial codes, and appeal processes.
• 14. Types of Bills.
• 15. Must know Value/Revenue/DX codes
• 16. Difference Between DPU & DPO

Skills

Hospital Billing

UB-04 CMS-1450

Payer guidelines

Data entry speed

Medical terminology

Education

Graduate from any discipline

Tools

Epic

Cerner

Athena

Job description

Revenue Cycle Representative AR - Hospital Billing

As a Revenue Cycle Representative specializing in Hospital Billing (HB), you will play a pivotal role in ensuring the accurate and efficient management of large-scale financial and administrative data processes within the institutional revenue cycle. Your primary responsibility will be to oversee and execute billing workflows for hospital and facility claims, ensuring seamless institutional financial operations and strict compliance with healthcare regulations.

Key Responsibilities for AR- HB:

• 1. Claim Management Follow-up.
• 2. Denial Management
• 3. Strong understanding of Hospital billing processes
• 4. Proficiency in medical billing software & Electronic Health Records (EHR).
• 5. Medicare DDE is added advantage
• 6. Review aging reports and prioritize accounts for follow-up based on outstanding balances and timely filing limits.
• 7. Follow up with insurance payers (Medicare, Medicaid, Commercial, etc.) via calls or portals to check claim status.
• 8. Analyze denied or underpaid claims, identify root causes, and take correctiv actions such as appeals or rebilling.
• 9. Collaborate with coding, billing, and patient access teams to resolve discrepancies and update account information.
• 10. Document all follow-up actions and maintain accurate notes in the billing system (e.g., Epic, Cerner, Athena, etc.)
• 11. Work to reduce A/R days and improve cash collections through proactive resolution strategies.
• 12. Escalate unresolved issues to Team Lead or Management for intervention.
• 13. Understand payer-specific guidelines, denial codes, and appeal processes.
• 14. Types of Bills.
• 15. Must know Value/Revenue/DX codes
• 16. Difference Between DPU & DPO

Note : Must have good knowledge in outpatient & Inpatient. Understanding the fields in UB04, importance inm each field.

Qualification: Graduate from any discipline.

Required Skills:

• Proven experience in healthcare Hospital Billing (RCM) with a focus on institutional facility claims and a strong understanding of UB-04 (CMS-1450).
• Strong knowledge of hospital insurance guidelines, institutional payer policies, facility reimbursement methodologies, and medical terminology
• Good reading, writing, and analytical skills paired with strong communication to collaborate effectively with colleagues and supervisors.
• Fast and accurate keyboard/typing skills for high-volume data entry into complex Hospital Information Systems (HIS) and EHR platforms.