RCM Specialist

Company Owerview :

CapMinds is a health-IT digital transformation partner for healthcare and related organizations worldwide. We provide technology research, solutions, and services for global businesses, enabling them to be more efficient, focused, and innovative.

Description :

We are looking for an experienced Revenue Cycle Management (RCM) Specialist with 4–5 years of proven expertise in end-to-end RCM operations. The ideal candidate will be responsible for managing and optimizing the complete revenue cycle, ensuring accuracy, compliance, and efficiency across all processes.

Key Responsibilities :

• Manage the full revenue cycle, including patient registration, insurance verification, charge capture, coding, claim submission, payment posting, denial management, and accounts receivable follow-up.
• Review patient accounts to ensure accurate ICD-10, CPT, and HCPCS coding, along with compliant billing practices.
• Investigate and resolve denied or rejected claims, coordinating timely resubmissions to minimize revenue loss.
• Collaborate with clinical teams to ensure documentation accurately supports coding and billing requirements.
• Optimize RCM processes to reduce denials, improve cash flow, and accelerate collections.
• Ensure compliance with HIPAA guidelines and payer-specific regulations.
• Prepare and present reports on billing performance, AR aging, and key revenue metrics.
• Identify and implement workflow improvements to drive efficiency and maximize revenue.

Requirements :