We are looking for an experienced RCM Specialist with at least 3+ years of hands-on experience across medical billing, payment posting, denial resolution, accounts receivable follow-up, and RCM reporting.

This role requires someone who can work independently, understand the full revenue cycle, identify claim issues, resolve denials, follow up with insurance payers, post payments accurately, and prepare meaningful reports for management and clients.

This is not a basic data-entry billing role. We need someone who understands how claims move from charge entry to payment, denial, correction, resubmission, and final resolution.

Key Responsibilities

Review and submit clean claims to insurance payers.
Verify claim accuracy, including CPT, ICD-10, modifiers, place of service, provider details, payer information, and patient demographics.
Work claim rejections and make corrections before resubmission.
Post insurance payments, patient payments, adjustments, contractual write-offs, and denials accurately.
Review ERA/EOB details and identify payment discrepancies, underpayments, overpayments, and incorrect adjustments.
Work insurance denials by identifying root causes, correcting claims, submitting appeals, and following up until resolution.
Handle AR follow-up for unpaid, underpaid, rejected, and denied claims.
Call insurance payers when needed to obtain claim status, denial reasons, payment details, appeal status, and corrected claim instructions.
Track denial trends and report recurring issues to management.
Prepare weekly and monthly RCM reports, including claims submitted, payments posted, denials worked, AR status, aging, unresolved claims, and payer issues.
Maintain accurate notes in the billing system for every action taken.
Communicate clearly with team members, managers, and clients regarding claim issues, pending items, and next steps.
Follow client-specific billing rules, payer guidelines, and internal SOPs.

Required Experience

Minimum 3+ years of medical billing / RCM experience.
Strong experience in billing, payment posting, denial resolution, and AR follow-up.
Ability to read and understand EOBs, ERAs, denial codes, claim status responses, and payer correspondence.
Experience working with commercial insurance, Medicare, Medicaid, and managed care plans.
Strong understanding of CPT, ICD-10, modifiers, POS, provider NPI, group NPI, taxonomy, and payer-specific billing rules.
Experience calling insurance payers and documenting claim follow-up.
Ability to generate and explain RCM reports.
Strong Excel or Google Sheets skills.
Excellent attention to detail.
Strong written and verbal communication skills.
Ability to work remotely with minimal supervision.
Must be reliable, organized, and able to meet daily and weekly productivity expectations.

Preferred Qualifications

Experience with multiple specialties such as behavioral health, primary care, internal medicine, pain management, therapy, or specialty practices.
Experience with systems such as Tebra/Kareo, eClinicalWorks, DrChrono, Office Ally, AdvancedMD, Athena, CollaborateMD, or similar platforms.
Experience reviewing aging reports, denial reports, rejection reports, payment reports, and productivity reports.
Experience identifying billing process gaps and recommending improvements.
Familiarity with credentialing-related claim issues, payer enrollment problems, EFT/ERA issues, and provider setup problems.

Success Metrics

The selected candidate will be expected to:

Submit clean claims accurately and on time.
Reduce claim rejections and recurring billing errors.
Work denials with proper root-cause analysis, not just basic status checks.
Keep AR follow-up notes accurate and complete.
Post payments correctly with proper adjustments.
Identify underpayments and unresolved payer issues.
Prepare clear reports that show what was worked, what is pending, and what needs escalation.
Meet assigned productivity and quality targets.

Work Schedule

Remote position. Candidate must be available during agreed working hours and must be able to communicate regularly with the team. Availability during U.S. business hours is preferred for payer calls and internal coordination.

Compensation

Compensation will be based on experience, skill level, and availability. Please include your expected monthly compensation when applying.

How to Apply

Please submit your resume and answer the following questions:

How many years of hands-on RCM experience do you have?
Which areas have you personally worked in: billing, payment posting, denial resolution, AR follow-up, reporting?
Which billing systems or practice management systems have you used?
Which specialties have you worked with?
Are you comfortable calling insurance payers directly?
Can you read and interpret EOBs, ERAs, denial codes, and claim status responses independently?
What RCM reports have you prepared in your previous roles?
What is your expected monthly compensation?
Are you available to work in U.S. EST time zones?

Applicants without hands-on experience in billing, posting, denials, and AR follow-up will not be considered.

Pay: ₹25,000.00 - ₹35,000.00 per month

Benefits:

Work from home

Application Question(s):

How many years of hands-on RCM experience do you have?
Which areas have you personally worked in: billing, payment posting, denial resolution, AR follow-up, reporting?
Which billing systems or practice management systems have you used?
Which specialties have you worked with?
Are you comfortable calling insurance payers directly?
Can you read and interpret EOBs, ERAs, denial codes, and claim status responses independently?
What RCM reports have you prepared in your previous roles?
What is your expected monthly compensation?
Are you available to work in U.S. EST time zones?

Work Location: Remote

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