RCM Executive

Company Description

Ambit Global Solution is a leading medical and dental billing and revenue cycle management company based in Ahmedabad. The company helps organizations maximize revenue and reduce operating costs with a highly trained team of experts. Ambit's powerful technology solutions and client-focused service enhance the efficiency and profitability of medical practices, hospitals, dental groups, GPOs, and third-party administrators. Client satisfaction is the primary focus, supported by detailed processes, experienced personnel, cutting-edge technology, and a forward-thinking approach.

Job Title

Accounts Receivable Specialist – Revenue Cycle Management (RCM)

Job Summary

The Accounts Receivable Specialist under the RCM process is responsible for managing and optimizing all activities related to the collection of payments for healthcare services rendered. This includes following up with insurance carriers, addressing claim denials, posting payments, and maintaining precise financial documentation to support revenue integrity.

Key Responsibilities

• Manage the accounts receivable process, including billing, claims follow-up, payment posting, and collections for assigned healthcare clients.
• Review AR aging reports to identify outstanding or delinquent accounts and take appropriate follow-up actions.
• Investigate and resolve claim denials, discrepancies, and underpayments through communication with insurance companies and patients.
• Submit and appeal claims to payers, ensuring compliance with payer-specific guidelines and regulatory requirements.
• Post payments accurately into the billing system and reconcile accounts to maintain up-to-date financial records.
• Communicate effectively with cross-functional teams such as billing, coding, and customer service to resolve complex issues affecting claim payment.
• Generate reports on AR performance metrics such as Days Sales Outstanding (DSO), denial rates, and collection efficiency.
• Maintain data accuracy and integrity in the AR management system, ensuring all patient information, claims, and payments are properly documented.
• Support management during audits and compliance reviews by providing documentation and analysis as required.
• Participate in process improvement initiatives to streamline AR workflows and improve overall revenue cycle performance.

Required Qualifications and Skills

Performance Indicators

This role is integral to the overall financial health of healthcare organizations, ensuring that services rendered translate into accurate and timely reimbursements — the core objective of the Revenue Cycle Management function.