Posted:4 hours ago|
Platform:
Hybrid
Full Time
Greetings from Talent Sketchers
Kindly find the details below
We are seeking a highly skilled and detail-oriented BA with specialist RCM knowledge to help in detailing requirements for end-to-end revenue cycle operations. The ideal candidate will have hands-on experience across front-end, mid-cycle, and back-end RCM processes, with a strong understanding of payer requirements, coding standards, and claims workflows. Here is some more details
Key Responsibilities: The candidate should be experienced in the areas shown below and have experienced in creating detailed requirements.
Front-End RCM• Patient registration and intake with accuracy• Insurance eligibility and benefits verification• Prior authorization processes and coverage validation• Documentation of medical necessity and payer requirementsMid-Cycle RCM• CPT, ICD-10, HCPCS, J-Codes, and SNOMED• Specifics for submission of 837P and 837I• Understand payer-specific rules and clean claim submission• Denials and resubmissions with appropriate documentationBack-End RCM• Posting payments and Reconciliation of claims using ERA and EOBs• Analysis of payment variances and resolution of discrepancies• Management of patient balances and coordination of billing follow-ups• Resolution process with finance and customer service teams
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