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Interscripts Software
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RCM analyst/Senior RCM analyst

RCM analyst/Senior RCM analyst

Interscripts Software

2 - 4 years

4 - 8 Lacs

Hyderabad

Posted:3 weeks ago| Platform:

Apply

Skills Required

Revenue Cycle Management Epic Strong verbal and written communication skills. US Healthcare HMO Strong Communication Skills

Work Mode

Work from Office

Job Type

Full Time

Job Description

Designation: RCM analyst/Senior RCM analyst

Location: Hyderabad

Experience: Minimum of 2 years in US healthcare RCM

Key Skills:

Knowing EPIC (EHR software) will be an added advantage

Claim Investigation & Resolution

Analyze
denied or delayed HMO claims
and identify root causes (e.g., coding errors, authorization issues, eligibility mismatches).
Strong understanding of UB04 and CMS 1500 forms

Provider Support via Call & Chat

Act as a
frontline liaison
for providers, resolving claim-related issues in real time.
Guide
payer-specific rules
, documentation requirements, and appeals processes.
Escalate complex issues to internal teams or payers when necessary.

Eligibility & Authorization Verification

Confirm patient eligibility and authorization status before claim submission.
Educate providers on
HMO referral protocols
and network restrictions.

Denial Management & Appeals

Track denial trends, monitor appeal outcomes, and update providers accordingly
Prepare and submit
appeals
with supporting documentation.

Compliance & Documentation

Ensure all interactions and claim actions comply with
HIPAA
and payer policies.
Maintain detailed logs of provider communications and claim resolutions.

Strong understanding of UB04 and CMS 1500 formsRole & responsibilities

Preferred candidate profile

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