RCM Specialist

About the role

Requirements

• Education: Bachelor’s in:  Health Informatics ,Healthcare Administration / Hospital Management , Business Administration , Management Information Systems
• Experience: Years: 2 – 3 Years
• - Fluent in English (spoken & written).
• - Advanced Excel skills and data analysis.
• - Hands-on experience managing the full Revenue Cycle Management (RCM) process end-to-end (A-Z), including registration, eligibility, pre-authorization, charging, coding, billing, claims submission, rejection management, follow-up, and collections.
• - Strong knowledge of Medical Claims, Billing, and Health Insurance Operations.
• - Good knowledge of Hospital Information Systems (HIS) and Claims Management Systems.
• - Strong knowledge of CCHI regulations, requirements, and healthcare insurance compliance standards.
• - Good understanding of CBAHI requirements and healthcare quality standards.
• - Ability to identify root causes of claim rejections and implement corrective actions to improve collections.
• - Strong analytical, communication, and problem-solving skills.
• - Ability to work effectively with cross-functional teams.

Skills

• Revenue Cycle Management
• English (fluent)
• Advanced Excel
• data analysis
• registration
• eligibility
• pre-authorization
• charging
• coding
• billing
• claims submission
• rejection management
• follow-up
• collections
• Medical Claims
• Billing
• Health Insurance Operations
• Hospital Information Systems (HIS)
• Claims Management Systems
• CCHI regulations
• CBAHI requirements
• root cause analysis
• corrective actions
• analytical
• communication
• problem-solving
• cross-functional collaboration