AR - US Healthcare RCM | Night Shift

Job Description:

Greenhive Billing Solutions is hiring an experienced Senior RCM Specialist with 1-5 years of hands-on experience in end-to-end US Healthcare Revenue Cycle Management.

This is a Onsite night-shift role. However, the candidate should be open to relocating to Indore, Madhya Pradesh, if required in the future based on business needs.

The ideal candidate should have strong practical knowledge of the complete RCM lifecycle, including eligibility verification, charge entry, claim submission, rejection handling, denial management, AR follow-up, payment posting coordination, patient balance review, and reporting.

This role is best suited for a candidate who has worked beyond one single process and understands how front-end errors impact claim submission, denials, collections, and AR aging. The candidate should be able to independently analyze claim issues, identify root causes, coordinate with internal teams, and ensure timely reimbursement.

Key Responsibilities:

End-to-End RCM:

• Understand and manage the complete US healthcare RCM lifecycle from eligibility to payment resolution
• Review patient demographics, insurance details, provider details, CPT, ICD-10, HCPCS, modifiers, and billing information
• Identify errors in eligibility, authorization, charge entry, coding, claim submission, payment posting, and AR follow-up
• Coordinate with EV, charge entry, coding, payment posting, credentialing, and AR teams to resolve claim issues
• Help improve clean claim submission, reduce denials, and improve collections

Accounts Receivable / Insurance Follow-up:

• Perform AR follow-up on unpaid, denied, rejected, and underpaid claims
• Work aging reports across 30, 60, 90, and 120+ day buckets
• Follow up with insurance companies through calls, payer portals, and online tools
• Analyze claim status, payer responses, EOBs, ERAs, and denial reasons
• Ensure timely claim resolution and reduce AR aging

Denial Management & Appeals:

• Review and resolve denials related to eligibility, authorization, coding, credentialing, medical necessity, timely filing, COB, duplicate claims, and payer guidelines
• Prepare appeals, reconsiderations, corrected claims, and resubmissions as needed
• Identify recurring denial trends and escalate root causes to leadership
• Recommend process improvements to prevent repeat denials

Payment & Reimbursement Review:

• Review EOBs / ERAs to understand payment, denial, adjustment, and patient responsibility details
• Identify underpayments, incorrect adjustments, and payer reimbursement issues
• Coordinate with payment posting team to correct posting errors or payment discrepancies
• Support reconciliation and accurate account resolution

Reporting & Quality:

• Maintain accurate documentation of all actions in billing systems
• Track productivity, quality, collections, and AR resolution metrics
• Share updates on high-priority claims, old AR, denial trends, and payer issues
• Support quality improvement and process standardization

Required Skills:

• Minimum 5+ years of experience in US Healthcare RCM / Medical Billing
• Strong end-to-end RCM knowledge across eligibility, charge entry, claim submission, denials, AR, and payment workflows.
• Strong experience in US healthcare AR follow-up and insurance follow- up.
• Experience handling denial management, appeals, corrected claims and claims resubmissions.
• Strong EOB / ERA analysis skills.
• Understanding of CPT, ICD-10, HCPCS, modifiers and payer guidelines
• Knowledge of Medicare, Medicaid, commercial payers and payer portals.
• Ability to work independently on complex claim scenarios
• Strong written and verbal communication skills
• Strong documentation accuracy and attention to detail
• Good excel and reporting skills
• Comfortable working in Night Shift Onsite from Indore office

Preferred Software Knowledge :

• Athena
• Kareo
• eClinicalWorks
• AdvancedMD
• NextGen
• Epic
• PracticeSuite
• Office Ally
• Other EMR / HER / practice management systems

Preferred Background :

• Experience working in a medical billing company, RCM company, healthcare BPO/KPO, or provider billing office.
• Experience handling multi-specialty RCM.
• Experience with high-dollar claims, old AR cleanup, and denial trend analysis.
• Experience coordinating with EV, charge Entry, coding, credentialing and payment posting teams.

Key Competencies:

• End-toend RCM thinking
• Strong ownership mindset
• Excellent follow-up discipline
• Problem-Solving ability
• Strong payer communication skills
• Ability to identify root cause, not just work claims
• High accuracy in documentation
• Process-driven approach
• Ability to work independently in a remote setup

Why Join Greenhive Billing Solutions?

• Opportunity to work on end-to-end US Healthcare RCM
• Exposure to multiple RCM functions including AR, denials, billing, payment review and process improvement
• Long-term growth opportunity with a growing company
• Professional and supportive work environment
• Opportunity to grow into leadership or specialized RCM roles.

How to Apply

Apply via Naukri.com