Job Description
Key Responsibilities:
Manage and coordinate daily revenue cycle management activities within the healthcare facility.
Oversee patient registration, insurance verification, billing, claims submission, and payment follow-ups.
Ensure accurate patient information, medical records, and billing documentation.
Coordinate with insurance companies and third-party administrators (TPAs) regarding claim approvals and settlements.
Monitor claim submissions, rejections, denials, and reimbursement processes.
Follow up on outstanding claims and pending payments to ensure timely collections.
Identify billing errors, claim discrepancies, and revenue leakage and coordinate corrective actions.
Assist in resolving insurance-related issues and billing disputes.
Maintain accurate RCM reports, financial records, and claim status documentation.
Coordinate with medical, billing, finance, and insurance departments to improve workflow efficiency.
Monitor key performance indicators (KPIs), including claim rejection rates, collection rates, and outstanding receivables.
Ensure compliance with healthcare billing policies, insurance regulations, and data confidentiality requirements.
Qualifications and Requirements
Bachelor's degree in Healthcare Administration, Hospital Management, Finance, Accounting, or a related field.
Previous experience in Revenue Cycle Management (RCM), medical billing, or hospital administration is preferred.
Strong knowledge of healthcare revenue cycle processes, including patient registration, charge capture, claims submission, and payment posting.
Understanding of health insurance policies, TPA procedures, pre-authorizations, and claims processing.
Knowledge of medical terminology, coding, and billing procedures is an advantage.
Familiarity with hospital management systems (HMS), electronic medical records (EMR), and billing software.
Proficiency in MS Excel and financial reporting tools.
Strong analytical, organizational, and problem-solving skills.
Excellent communication and coordination abilities.
High attention to detail and accuracy.
Ability to manage multiple tasks and meet deadlines.
Commitment to patient confidentiality and professional standards.
Ready to apply?
Review the requirements, then send your application to the employer.
