Certified RCM Consultant

4 days ago

Karachi, Sindh, Pakistan Eplanet Global Pakistan Full time 900,000 - 1,200,000 per year

Position Overview:

We are seeking an experienced and certified
RCM Consultant
to join our team. The ideal candidate will have in-depth knowledge of the US healthcare system, revenue cycle management processes, and medical billing practices. This role requires a professional with proven expertise in managing end-to-end RCM operations, ensuring compliance, and optimizing reimbursement cycles.

Key Responsibilities:

  • Oversee and manage
    end-to-end RCM processes
    including charge entry, claim submission, payment posting, denial management, and AR follow-up.
  • Ensure compliance with
    US healthcare billing regulations
    and payer-specific requirements.
  • Analyze denial trends, recommend corrective actions, and implement
    process improvements
    .
  • Collaborate with clients, physicians, and insurance companies to resolve claim issues and maximize reimbursements.
  • Maintain accurate documentation and reporting of billing activities.
  • Provide
    expert consultation
    on RCM strategies and process optimization.
  • Train and mentor junior billing staff as needed.
  • Stay updated on
    industry standards, regulations, and coding changes
    (ICD, CPT, HCPCS).

Requirements:

  • Mandatory certification
    in one of the following:
  • CPB (Certified Professional Biller – AAPC)
  • CMRS (Certified Medical Reimbursement Specialist – AMBA)
  • CBCS (Certified Billing & Coding Specialist – NHA)
  • Minimum 3 years of proven experience
    in US medical billing / RCM.
  • Strong knowledge of
    billing software, clearinghouses, and EHR systems
    .
  • Excellent understanding of insurance guidelines (Medicare, Medicaid, commercial payers).
  • Strong
    analytical, problem-solving, and communication skills
    .
  • Ability to work independently and within a team.

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