RCM Associate

About company

EMPClaims was recently recognized as a Top 10 vendor for RCM Services in the US, and we take pride in the quality of our services. Our customers include large health systems and small medical practices.

We offer you a competitive compensation package along with the opportunity to learn on the job, develop knowledge of the process, and grow your career.

• AR Analyst

Roles and Responsibilities

1. Review the Claim status & update accordingly via Calls
2. Communicate effectively, via phone and email
3. Evaluation of clinical documentation.
4. Follow the Patient Claim Plans

Required Qualifications & Skills:

1. Excellent verbal & written communication & listening skills.
2. Requires working knowledge of MS Office (Excel, Word)
3. Good Understanding of the US accent
4. Should be open for fixed night shift (

   06:00 PM to 03:00 AM)

• Payment Posting Analyst

The Payment Posting Analyst will be responsible for accurately posting and reconciling payments, adjustments, and denials received from various payers. The ideal candidate should have a strong understanding of ERA/EOB posting, payment reconciliation, and patient statement management.

Key Responsibilities

1. Accurately post and reconcile payments from insurance companies, patients, and government payers (ERA/EOB).
2. Verify payment amounts, adjustments, and denials as per payer remitance advice.
3. Enter payment data into the billing system and ensure timely, error-free posting.
4. Review and analyze EOBs and ERAs to identify discrepancies, underpayments, or overpayments.
5. Investigate and resolve payment discrepancies or posting errors promptly.
6. Work with the denial management team to resolve claim denials and ensure accurate reimbursement.
7. Perform daily and monthly reconciliations of posted payments with bank deposits.
8. Generate and manage patient statements and ensure accurate account balances.
9. Identify and report any irregularities or variances in cash reconciliation.

• Billing Analyst

Medical Billing Associate

Key Responsibilities

1. Prepare, review, and submit accurate

   medical claims

   to insurance companies electronically and manually.

2. Monitor and follow up

   on unpaid or delayed claims within the standard billing cycle timeframe.

3. Correct and re-submit

   rejected or denied claims after verifying and resolving issues with payers.
4. Work with the

   coding team

   to ensure accurate CPT, ICD, and modifier usage before claim submission.
5. Maintain detailed records of all billing and payment activities in the billing system.
6. Identify

   billing errors, underpayments, or trends

   affecting reimbursement and escalate as needed.

7. Stay current

   with payer guidelines, insurance policies, and updates in medical billing codes.
8. Ensure strict adherence to

   HIPAA compliance

   and patient data confidentiality.
9. Coordinate with AR, Payment Posting, and Credentialing teams for smooth end-to-end RCM flow.
10. Meet or exceed

    productivity and accuracy

    targets as defined by management.
11. Participate in process improvement initiatives to optimize claim turnaround and reduce denials.