Senior Healthcare BPO Specialist

3 days ago

Lahore, Punjab, Pakistan AppsGenii Technologies Full time 900,000 - 1,200,000 per year

We are seeking experienced
Senior Healthcare BPO Specialists
to manage end-to-end healthcare processes, ensure compliance with industry regulations, and lead operational excellence. The ideal candidate should have strong expertise in
US healthcare processes, RCM (Revenue Cycle Management), medical billing, claims, AR follow-up, and denial management.

Key Responsibilities:

  • Manage and oversee
    end-to-end healthcare BPO operations
    (billing, claims processing, AR follow-up, payment posting, and denial management).
  • Ensure compliance with
    HIPAA, ICD, CPT, and other regulatory guidelines.
  • Train, mentor, and guide junior team members to improve process accuracy and efficiency.
  • Collaborate with clients and internal teams to resolve escalations, discrepancies, and complex cases.
  • Monitor
    daily, weekly, and monthly performance metrics
    to meet SLAs and KPIs.
  • Implement best practices to
    reduce denials, improve collections, and enhance client satisfaction.
  • Prepare reports, analyze trends, and suggest process improvements to management.

Required Skills & Qualifications:

  • Bachelor's degree (preferred in healthcare, business, or related field).
  • 3–5+ years of relevant experience
    in healthcare BPO / medical billing.
  • Strong knowledge of
    US healthcare system, payer processes, insurance guidelines, and RCM cycle.
  • Proficiency in
    MS Office tools and medical billing software/EMR systems
    (e.g., Athena, Kareo, AdvancedMD, eClinicalWorks).
  • Excellent communication, client handling, and problem-solving skills.
  • Ability to lead a team and manage multiple priorities in a fast-paced environment.

Preferred Skills:

  • Certification in
    CPC, CPC-H, or equivalent
    (a plus).
  • Experience in handling
    payer audits, compliance checks, and quality control.
  • Exposure to
    voice and non-voice healthcare BPO operations.

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