We are hiring for **Revenue cycle specialist(US Health care)**
Exp:**5\+ Years (US health care)**
Qualification: **Any Graduate**
Location **:Nallagandla,Hyd**
5 Days working
Male or Female
· **Manage End\-to\-End Revenue Cycles:** **Execute comprehensive RCM workflows for US\-based Durable Medical Equipment (DME) providers, ensuring financial integrity from claim submission to final payment.**
· Platform Mastery: Utilize Brightree as the primary system of record to manage patient accounts, process claims, and maintain real\-time data accuracy.
· Precision Cash Posting: Perform high\-volume posting of insurance and patient payments (ERAs and manual EOBs) with a focus on reconciling bank deposits to system entries.
· Strategic AR Management: Conduct rigorous follow\-up on outstanding claims, identifying aging trends and prioritizing high\-dollar accounts to minimize Days Sales Outstanding (DSO).
· **Denial Resolution \& Analysis**: Investigate claim rejections and denials; perform root\-cause analysis to implement corrective actions and resubmit clean claims for reimbursement.
· Process Automation: Leverage AI\-driven tools and Brightree’s advanced features to automate repetitive billing tasks and enhance the speed of the revenue cycle.
· Payer Compliance: Stay current on Medicare, Medicaid, and commercial insurance guidelines (HCPCS, modifiers, and documentation requirements) to ensure 100% compliance.
· Cross\-Border Collaboration: Partner closely with US\-based clinical teams and client stakeholders via virtual meetings to resolve documentation gaps and refine billing assumptions.
· Reporting \& Insights: Generate and present clear, client\-ready reports on key performance indicators (KPIs), providing actionable insights into the client’s financial health.
· Operational Excellence: Identify opportunities to streamline RCM processes while bridging cultural and operational nuances between the India\-based delivery center and US\-based providers.
· **3\+ years of experience in a US Healthcare RCM role, specifically focused on Durable Medical Equipment (DME) or Home Medical Equipment (HME).**
· Strong understanding of DME\-specific billing requirements, including CMNs (Certificates of Medical Necessity), Prior Authorizations, and US GAAP principles related to healthcare.
· Exceptional attention to detail with the ability to navigate complex payer portals and interpret intricate Explanation of Benefits (EOB) statements.
· Proficient in Microsoft Excel (VLOOKUPs, Pivot Tables) and experience leveraging AI tools (e.g., ChatGPT, Copilot, Gemini) to optimize workflow efficiency.
· Communication Skills: Excellent verbal and written English, with the ability to clearly explain denial reasons and financial discrepancies to US\-based stakeholders.
· Reliability \& Agility: Process\-oriented and adept at managing high volumes of data while successfully adapting to Eastern Standard Time (EST) shift requirements.
· Cultural Competence: Thrives in a collaborative, cross\-cultural environment and is comfortable using remote collaboration tools like Google Meet, Slack, and Monday.com.
· Eager to grow with Our with a desire for long\-term professional advancement.
Pay: ₹500,000\.00 \- ₹900,000\.00 per year
Work Location: In person
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