Revenue Cycle Management Specialist

Edge; Pakistan; On-site; PKR 1,200,000 - 1,800,000; Full time

Job summary

EDGE is seeking a Revenue Cycle Management Specialist to join our healthcare operations team. This in-office role requires a candidate to be willing to work from our Lahore or Islamabad offices and to handle the full revenue cycle including billing, claims submission, and AR follow-up.

You will verify insurance eligibility, ensure clean claims, and resolve denials while maintaining HIPAA compliance and delivering high-quality service. This position follows a 5-day work week with standard hours.

Qualifications

• 2+ years of experience in medical billing and accounts receivable within a US healthcare environment.
• Strong understanding of medical billing, insurance verification, claims submission, and accounts receivable follow-up.
• Experience resolving claim edits, denials, and payment discrepancies.
• Comfortable working with Electronic Health Records (EHR) and Practice Management Systems.

Responsibilities

• Verify patient demographic and insurance information to ensure clean claim submission.
• Review and confirm insurance eligibility before services are billed.
• Resolve insurance verification issues and escalate complex cases when needed.
• Process and submit medical claims accurately and in a timely manner.
• Identify and resolve claim edits and billing rejections.
• Process account adjustments, refunds, and corrections to maintain accurate balances.
• Follow up on outstanding claims and accounts receivable to meet productivity and KPI targets.
• Work closely with internal departments to ensure efficient revenue cycle operations.
• Maintain compliance with HIPAA and organizational policies.
• Support quality improvement initiatives, audits, and electronic health record documentation.

Skills

Medical billing

Accounts receivable

Insurance verification

Claims submission

HIPAA compliance

Tools

NextGen

Practice Management Systems

Healthcare billing platforms

Insurance eligibility verification tools

Job description

** Before you apply, this is an in-office job. Candidates must be willing to work from our Lahore or Islamabad Office ****

Revenue Cycle Management Specialist

Who We Are

EDGE is building a bridge between Top Global Talent and the US Healthcare & Insurance Industry. We are on a mission to create a borderless network of exceptional talent with people at the center of everything we do. See our values and more on onedge.co.

About the Role

We are looking for an experienced Revenue Cycle Management Specialist to join our healthcare operations team. In this role, you will support the full revenue cycle by ensuring accurate billing, claims processing, insurance verification, and accounts receivable follow-up. You will play a key role in maximizing reimbursement while maintaining compliance with healthcare regulations and delivering high-quality service.

Key Responsibilities

• Verify patient demographic and insurance information to ensure clean claim submission.
• Review and confirm insurance eligibility before services are billed.
• Resolve insurance verification issues and **escalate** complex cases when needed.
• Process and submit medical claims accurately and in a timely manner.
• Identify and resolve claim edits and billing rejections.
• Process account adjustments, refunds, and corrections to maintain accurate balances.
• Follow up on outstanding claims and accounts receivable to meet productivity and KPI targets.
• Work closely with internal departments to ensure efficient revenue cycle operations.
• Maintain compliance with HIPAA and organizational policies.
• Support quality improvement initiatives, audits, and electronic health record documentation.
• Perform other related duties as assigned.

Requirements

• Able to work in office: Lahore or Islamabad - Non-negotiable
• Able to work full time: Monday-Friday 8am to 5pm PST- Non-negotiable
• 2+ years of experience in medical billing and accounts receivable within a US healthcare environment.
• Strong understanding of medical billing, insurance verification, claims submission, and accounts receivable follow-up.
• Experience resolving claim edits, denials, and payment discrepancies.
• Comfortable working with Electronic Health Records (EHR) and Practice Management Systems.
• Strong computer skills and the ability to quickly learn new software.

Experience with systems such as:

• NextGen
• Practice Management Systems (PMS)
• Healthcare billing platforms
• Insurance eligibility verification tools

What We're Looking For

We're seeking someone who is proactive, detail-oriented, and passionate about healthcare revenue cycle management. The ideal candidate takes ownership of their work, enjoys solving billing challenges, and is committed to improving financial outcomes while ensuring an excellent patient experience.