
RCM Specialist
3 days ago
Location: Lahore (Remote)
Shift Timing: 6:00 PM – 3:00 AM (Pakistan Standard Time)
Employment Type: Full-time
Key Responsibilities
- Perform Verification of Benefits (VOBs) to confirm insurance eligibility and coverage.
- Accurately manage payment posting for payers and patients.
- Handle Accounts Receivable (AR) by following up on outstanding claims and reducing aging.
- Manage denials and rejections, identify root causes, and ensure timely resolution.
- Prepare and submit appeals with supporting documentation and follow up as needed.
- Process billing for Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) services.
- Collaborate with providers, internal teams, and insurance companies to ensure smooth claim processing.
- Maintain accurate and up-to-date records in RCM systems.
- Use tools such as Tebra, 8x8, Trizetto, and others to enhance workflow efficiency.
Required Skills & Qualifications
- 3–5 years of experience in medical billing or RCM operations.
- Strong understanding of insurance workflows (VOBs, AR, denials, appeals).
- Familiarity with RPM and CCM billing guidelines.
- Basic proficiency in MS Excel (sorting, filtering, formulas).
- Hands-on experience with platforms such as Tebra, Trizetto, and 8x8.
Preferred Qualifications
- Experience with Electronic Health Record (EHR) systems.
- Knowledge of HIPAA compliance and medical billing standards.
- Certification in medical billing or coding (CPC, CPB) is a plus.
Job Type: Full-time
Work Location: Remote
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