Job Description

Location: India, Remote

Employment Type: Full-Time

Experience: 1+ years

Industry: US Healthcare / Revenue Cycle Management

About the Role

We are looking for a highly detail-oriented US Healthcare RCM & Billing Analyst to support revenue cycle management for US-based primary care practices.

This role is ideal for someone with hands-on experience in US medical billing, payer processes, claims, payment reconciliation, denials, and advanced Excel-based analysis. You will work directly with US healthcare workflows and be responsible for ensuring billing accuracy, identifying revenue leakage, investigating payment issues, and continuously improving operational processes.

You will also work with large, multi-tab Excel workbooks and AI-assisted workflows: strong analytical and technical skills essential.

Key Responsibilities

Revenue Cycle Management

Verify patient eligibility for services rendered.
Review clinical documentation and convert activity into submission-ready billing.
Perform billing quality assurance, including checks for:
Duplicate billing
Missing information
Incorrect coding
Incorrect time entries
Other billing exceptions
Reconcile expected payments against actual payments and investigate discrepancies.
Research claims, payment issues, denials, and underpayments and identify root causes.
Coordinate with internal stakeholders and payers to resolve outstanding issues.
Conduct payer outreach by phone and other approved communication channels.
Prepare monthly partner invoices and supporting billing summaries.

Data Analysis & Technical Review

Audit large, high-volume legacy datasets across complex, multi-tab Excel workbooks.
Validate historical outputs against payer-specific billing rules and requirements.
Identify recurring errors, process gaps, and potential sources of revenue leakage.
Perform detailed QA and exception analysis across large datasets.
Maintain clear calculation logic, supporting documentation, and audit trails for analyses and findings.

Process & Workflow Optimization

Identify opportunities to improve billing and RCM workflows.
Optimize Excel-based billing workbooks and reporting processes.
Support and improve AI-assisted workflows used within assigned RCM processes.
Recommend process improvements based on recurring errors, operational data, and root-cause analysis.
Contribute to continuous improvement initiatives across the revenue cycle.

Collaboration

Communicate regularly with US-based stakeholders.
Clearly document issues, findings, calculations, and recommended actions.
Operate as an extension of the client's internal RCM team.
Escalate material issues promptly and follow through to resolution.

Required Qualifications

1+ years of experience in US healthcare RCM, medical billing, or healthcare revenue cycle operations.
Strong work from home setup - you will be handling PHI and must be HIPAA compliant. Your working port must have strong WiFi and no background noise.
Strong understanding of the US healthcare billing and payer ecosystem.
Hands-on experience with:
Eligibility verification
Medical billing
Claims
Payment posting/reconciliation
Denials and troubleshooting
Payer follow-up
Advanced Microsoft Excel skills, including working with large, multi-tab workbooks and complex datasets.
Strong analytical and problem-solving skills.
Excellent attention to detail and ability to identify inconsistencies in large datasets.
Strong written and verbal English communication skills.
Ability to independently investigate problems and identify root causes.
Comfortable working with structured processes as well as ambiguous or evolving workflows.
Ability to work effectively with US-based teams and stakeholders.

Preferred Qualifications

Experience supporting US medical systems, behavioral health a strong plus.
Experience with payer-specific billing rules and workflows.
Experience with RCM reporting, reconciliation, or revenue leakage analysis.
Experience auditing historical billing data.
Experience with EHR, billing, clearinghouse, or RCM platforms.
Experience working with AI-assisted tools or automation in healthcare operations.
Strong Excel skills including PivotTables, XLOOKUP/VLOOKUP, SUMIFS, data validation, and complex formulas.

What We're Looking For

The ideal candidate is more than a transactional billing processor. You should be someone who can:

Understand the why behind an RCM discrepancy.
Analyze large datasets and identify patterns.
Trace an issue back to its root cause.
Work independently with limited supervision.
Catch errors before they become financial problems.
Clearly explain findings to US healthcare stakeholders.
Improve the process rather than simply follow it.

Working Hours

This role will support US-based healthcare operations - 4 hours per day need to align with US working hours, the other 4 are yours to choose.

Why Join Us

Work directly with US healthcare organizations and primary care practices.
Gain exposure to complex RCM, payer, and healthcare operations workflows.
Work at the intersection of healthcare operations, data, and AI-enabled workflows.
Opportunity to take ownership of processes and contribute to measurable operational improvements.
Remote role with an international healthcare operations team.