RCM executive

The Senior Executive – RCM is responsible for end-to-end revenue cycle operations, with a strong focus on charge posting, reconciliation, and overall production activities including charge posting, accounts receivable (AR), and patient statements.

The role ensures timely and accurate payment processing, high-quality output, SLA adherence, and efficient handling of clarifications, while supporting departmental KPIs and client expectations.

Genaral Responsibilities:

• Manage medical billing process from submission to payment posting.
• Ensure timely claims processing with accuracy and efficiency.
• Oversee charge posting, denial management, and RCM compliance
• Key Responsibilities
• 1. Payment Posting & Reconciliation
• • Post payments received via ERA/EFT and manual methods accurately within defined TAT:
• o ERAs within 8 hours
• o Manual payments within 16 hours
• • Review and process clearinghouse files, scanned documents, and correspondence.
• • Perform payment reconciliation by comparing clearinghouse data with internal systems.
• • Identify and resolve discrepancies in payments, adjustments, and balances.
• • Prioritize patient payments and notify clients accordingly.
• • Monitor payment flows and escalate deviations or issues promptly.
• 2. Production & RCM Operations
• • Achieve 100% daily production targets across:
• o Payment posting
• o Charge posting
• o AR follow-ups (denials, no response)
• o Patient statements
• • Ensure >99% accuracy in all transactions with minimal errors.
• • Meet or exceed SLA adherence of >98% for all deliverables.
• • Process and reconcile all RCM activities within defined timelines.
• • Ensure completion of all assigned tasks within SLA and quality benchmarks.
• 3. Clarifications & Communication
• • Track, review, and resolve payment clarifications within TAT.
• • Manage and respond to emails and tickets promptly.
• • Coordinate with internal teams for clarification closure.
• • Maintain regular communication with Team Leads and Managers on payment and production status.
• • Provide End-of-Day (EOD) updates and escalation reports.
• 4. Quality & Compliance
• • Maintain 98% quality in payment posting and >99% overall transaction accuracy.
• • Adhere strictly to HIPAA, ISMS, QMS, and organizational SOPs.
• • Follow client-specific guidelines and workflows
• • Participate in error correction, rework reduction, and quality improvement initiatives.
• • Ensure audit readiness with accurate and compliant documentation.
• 5. Accounts Receivable & Issue Resolution
• • Work on AR tasks including denials, follow-ups, and unresolved accounts.
• • Escalate critical issues such as global denials or payment discrepancies.
• • Support resolution of overpayments and reconciliation gaps.
• • Collaborate with relevant teams to close open items efficiently.
• 6. Reporting & Performance Tracking
• • Track and update daily production metrics
• • Share payment and production status reports with stakeholders.
• • Perform weekly and monthly reconciliation reviews across all sources.
• • Consolidate and report clarification trends and performance insights.
• • Contribute to KPI tracking and performance reviews.
• 7. Process Improvement & Team Support
• • Identify process gaps and support automation and efficiency improvements.
• • Review workflows and ensure adherence to process checklists.
• • Provide cross-training and knowledge sharing within the team.
• • Adapt to process changes, system upgrades, and client requirements.
• Interested candidates please share your CV’s @[email removed] or contact purushothuman at [phone removed] .