Rcm Analyst

3 - 6 years

5 - 6 Lacs

Posted:1 week ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Job Summary

RCM Trainer & Quality Analyst

Key Responsibilities

  • Deliver training and quality audits across the

    end-to-end RCM lifecycle

  • Provide subject matter expertise on:
    • Billing, Payment Posting, and AR functions
    • Roles and responsibilities across RCM departments
  • Conduct

    EOB analysis with numerical interpretation

  • Review and validate

    CMS-1500 and UB-04 claim forms

  • Handle

    denial management

    and complex

    AR follow-up scenarios

  • Ensure accuracy in

    payment methodologies

    and payer-specific guidelines
  • Support teams with deep knowledge of

    health plans and payer structures

  • Perform QA audits, share feedback, and drive continuous process improvement
  • Ensure adherence to

    HIPAA guidelines

  • Collaborate with stakeholders across

    India, USA, and Puerto Rico

  • Create SOPs, training materials, and knowledge documentation

Required Skills & Expertise

  • Strong backend knowledge of

    US Healthcare RCM

  • Hands-on experience with

    EPIC system

  • In-depth understanding of:
    • RCM terminologies
    • EOBs & payment posting
    • Denials & AR workflows
  • Experience in

    training delivery and/or quality auditing

  • Knowledge of

    HIPAA compliance

  • Excellent

    verbal and written communication skills

  • Ability to work with global teams and diverse stakeholders

Desired Experience

  • 3 - 6 years

    of relevant experience in US Healthcare RCM
  • Prior experience as

    RCM Trainer, QA, SME, or Lead

    is highly preferred

Education

  • Graduate/Postgraduate in any discipline
  • Healthcare certification is an added advantage

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