Revenue Management Specialist

About the Role:

We are looking for experienced professionals in Accounts Receivable (AR), Prior Authorization, Payment Posting, and, Eligibility & Benefits Verification within the U.S. Healthcare industry.

The ideal candidates should have hands-on experience in provider-side healthcare operations, strong communication skills, and a good understanding of medical billing processes.

Key Responsibilities:

• Accounts Receivable (AR): Manage claim follow-ups, denial management, outstanding balances, and payment tracking to ensure timely reimbursement.
• Prior Authorization: Process authorization requests, coordinate with insurance providers, and follow up on pending approvals.
• Payment Posting: Post insurance and patient payments accurately, reconcile payments against claims, review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs), and identify underpayments, denials, and discrepancies.
• Eligibility & Benefits Verification: Verify patients insurance coverage, eligibility, benefits, copayments, deductibles, and out-of-pocket expenses.
• Coordinate with healthcare providers, insurance payers, and patients to resolve billing, payment, and authorization-related queries.
• Follow up on outstanding claims, payment discrepancies, and pending authorization requests to ensure timely resolution.
• Maintain accurate documentation and adhere to payer guidelines, established procedures, and healthcare compliance requirements.

Mandatory Requirements:

• Minimum 2+ years of experience in U.S. healthcare provider-side operations.
• Hands-on experience in one or more of the following areas: Accounts Receivable (AR), Prior Authorization, Payment Posting, or Eligibility & Benefits Verification.
• Strong understanding of U.S. healthcare billing processes and insurance workflows.
• Excellent verbal and written communication skills.
• Flexibility and willingness to work in U.S. shifts.

Benefits and Perks:

• Transportation cab service provided.
• Transportation Bonus (if using a personal vehicle)
• Attendance bonus
• Yearly bonus