Job Description
Job Title: RCM / Medical Billing Specialist
Schedule: 5 Days a Week | Rotational Shifts | Rotational Week Off
Experience: 3 - 6 Years
Role Overview
We are looking for experienced professionals with hands-on expertise in U.S.
Healthcare Revenue Cycle Management (RCM) and medical billing troubleshooting.
The ideal candidate should have strong analytical skills, deep domain knowledge, and
the ability to resolve complex claim, posting, or configuration issues across multiple
billing systems.
This is a technical and analytical RCM support roleideal for those who go beyond
basic AR follow-up or call-center responsibilities to identify and fix systemic billing
issues.
Key Responsibilities
Provide Level 1 and Level 2 support for RCM workflows, including claim
submission, charge entry, payment posting, and denial management.
Troubleshoot payer rejections, configuration errors, and ERA posting
discrepancies.
Analyze EDI 835/837 transaction data to identify and resolve logic or
mapping issues.
Collaborate with clearinghouses (Waystar, Availity, Change Healthcare) to
address payer-related discrepancies.
Document recurring issues, perform root cause analysis, and work with
internal teams to prevent recurrence.
Communicate effectively with U.S. clients, ensuring clear, solution-oriented
updates and documentation.
Maintain compliance with HIPAA and 42 CFR Part 2 guidelines while
handling sensitive data.
Required Skills s Domain Expertise
Strong understanding of U.S. Healthcare RCM including charge entry,
payment posting, denial analysis, and AR follow-up.
In-depth knowledge of payer rules (Medicare, Medicaid, commercial
payers).
Working knowledge of CPT, ICD-10, HCPCS, modifiers, and ERA/EDI 835-
837 transactions.
Demonstrated ability to identify root causes behind denials and system-level
billing issues.
Technical Competencies
Hands-on Experience With One Or More Medical Billing Systems
CollaborateMD, Kareo, AdvancedMD, Athenahealth, eClinicalWorks,
DrChrono, NextGen, PracticeSuite, or similar.
Experience using clearinghouse portals such as Waystar, Availity, and
Change Healthcare.
Familiarity with ticketing tools like Zendesk, Freshdesk, or Salesforce
Service Cloud.
Strong Excel skills for reporting, validation, and analysis (pivot tables,
lookups).
Customer Support Competencies
Analytical thinker who investigates workflow issues instead of surface-level
resolutions.
Excellent written and verbal communication skills tailored for non-technical
audiences.
Ability to collaborate with internal product or development teams for
technical fixes and process improvements.
Proven record of maintaining high CSAT scores and quick response times.
Qualifications
Bachelor's Degree (preferably in Commerce, Healthcare Administration, or
related field).
3-6 years of relevant experience in U.S. Healthcare RCM.
Certifications preferred: HIPAA Awareness, AAPC CPC (in progress or
completed).
