RCM AR Specialist
Veradigm (company site, opens in a new tab)PuneOn-siteDirect career pageEst. 4–7.5 LPA
Posted on 17 Sept
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Job description
Structured overview of role & requirements
About This Role
- Manage and maximize accounts receivable collections for RCMS clients through detailed research, follow-up on medical insurance claims, and appeals preparation.
- Drive accounts receivable processes to meet key performance indicators (e.g., working 1,400 accounts per month) and support client services by handling client, patient, and carrier communications.
- Monitor and reconcile claims including held/unbilled vouchers, denial trends, patient balances, credits, and refunds; resolve complex payer denials and ensure secondary claims payment.
Minimum Requirements
- Work Experience Required: Not explicitly mentioned in the JD.
- Strong knowledge of medical insurance claims processing and appeals handling is mandatory.
- Must be proficient with client office management/administrator systems, clearinghouse and PM rejections, and SharePoint reference/maintenance.
- Must demonstrate ability to handle high-volume accounts receivable workload (target of 1,400 accounts per month) with accurate and compliant work.
Ideal Candidate Profile
- Experienced in healthcare revenue cycle management, specifically accounts receivable and payer claim denials resolution.
- Detail-oriented with capacity to manage complex claim reconciliations and client communications effectively.
- Capable of operating under KPI-driven environments with emphasis on error-free transactions and compliance outcomes.