Senior Specialist

Job Summary

Job Purpose and Position Overview: Senior Specialist in IMS, eCW, Athena and Carecloud with expertise in charge posting, payment posting, AR management, patient statements, and reporting. Acts as a subject matter expert (SME) for the team, provides advanced support in resolving complex issues, mentors junior specialists, and ensures process excellence and client satisfaction.

Responsibilities

• Oversee and validate charge posting, payment posting, AR follow-up, denial management, and reporting activities to ensure accuracy, compliance, and timely completion.
• Handle complex client, payer, and operational escalations, providing timely resolution and recommendations for issue prevention.
• Conduct root cause analysis of recurring denials, rejections, underpayments, and process discrepancies, and implement corrective actions to improve outcomes.
• Monitor operational and revenue cycle performance metrics, ensuring adherence to quality, productivity, and service delivery standards.
• Perform quality reviews, reconciliations, and audits to ensure compliance with payer regulations, client requirements, and organizational policies.
• Act as a Subject Matter Expert (SME) for Cardiology revenue cycle processes, supporting team members with process-related guidance and issue resolution.
• Mentor and train Specialists on process workflows, PMS applications, payer guidelines, and best practices to improve overall team performance.
• Support onboarding and cross-training initiatives to enhance workforce flexibility and knowledge retention.
• Collaborate with Team Leaders and Managers to identify process improvement opportunities, workflow enhancements, and automation initiatives.
• Assist in the preparation of operational reports, performance dashboards, audit findings, and client-facing insights.
• Support process transitions, new client implementations, and special projects as assigned.
• Ensure compliance with HIPAA, ISMS, QMS, payer regulations, and client-specific requirements.

Experience

5+ years

Job Type

Full time

Location

Tamil Nadu, India