RCM Specialist

About the role

Requirements

• Requirements
• - Previous experience in revenue cycle management and medical approvals is highly desirable.
• - Proficiency in using approval platforms is essential.
• - Strong analytical and problem-solving skills with the ability to identify and resolve billing issues.
• - Excellent communication and interpersonal skills, enabling effective collaboration with multidisciplinary teams.
• Job Requirements
• - Bachelor's degree is required
• - Advance verbal and written communication skills
• - Mid-level positions require +2 years of experience
• - Healthcare provider organizations (hospitals, clinics, medical practices)
• - Certified Professional( IFCE )
• - Certified Professional (RCM )

Responsibilities

• - Monitored compliance to ensure protocols align with standard CCHI policies.
• - Validated and entered patient information and insurance coverage into the appropriate computer systems.
• - Sent approvals and reports to insurance companies.
• - worked on the Naphies platform with a highly skilled professional team.
• - Handled Ministry of Health cases by submitting all necessary documents and investigations to support the approval requests made by the treating doctor.
• - Analyzed data on UCAFs before submitting it to insurance companies.
• - Provided medical guidance to the claims processing team, assisted with ICD coding, and reviewed insurance claim forms and supporting documents to ensure completeness and continuity in the claims process.

Skills

• Revenue cycle management
• ICD coding
• claims processing
• insurance billing
• data analysis
• UCAF data analysis
• approval platforms
• Ministry of Health case handling
• Naphies platform
• CCHI policy compliance
• communication and interpersonal skills