4 Rcm Cycle Jobs

Reports to (level of category): Manager - Operations Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost efficient with regards to processes, resource utilization and overall constant cost management Must operate utilizing aggressive operating metrics. Qualifications:Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers')Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM)Good communication Skills (both written & verbal) Skill Set:Candidate should be good in Denial ManagementCandidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on DenialsAbility to interact positively with team members, peer group and seniors.Subject matter expert in AR follow upDemonstrated ability to exceed performance targetsAbility to effectively prioritize individual and team responsibilitiesCommunicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Reports to (level of category) : Senior Operations Manager Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. a) Day-to-day operations b) People Management (Work Allocation, On job support, Feedback & Team building) c) Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP) d) Reports (Internal and Client performance reports) e) Work allocation strategy f) CMS 1500 & UB04 AR experience is mandatory. g) Span of control - 80 to 100 h) Thorough knowledge of all AR scenarios and Denials i) Expertise in both Federal and Commercial payor mix j) Excellent interpersonal skills h) Should be capable to interact with US clients and manage escalations Qualifications Graduate in any discipline from a recognized educational institute Good analytical skills and proficiency with MS Word, Excel and PowerPoint Good communication Skills (both written & verbal) Skill Set Candidate should be good in Denial Management Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials. Ability to interact positively with team members, peer group and seniors. Demonstrated ability to exceed performance targets. Ability to effectively prioritize individual and team responsibilities. Communicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Reports to (level of category): Manager - Operations Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost efficient with regards to processes, resource utilization and overall constant cost management Must operate utilizing aggressive operating metrics. Qualifications:Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers')Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM)Good communication Skills (both written & verbal) Skill Set:Candidate should be good in Denial ManagementCandidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on DenialsAbility to interact positively with team members, peer group and seniors.Subject matter expert in AR follow upDemonstrated ability to exceed performance targetsAbility to effectively prioritize individual and team responsibilitiesCommunicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Role & re Job Title: AR Caller / RCM Specialist Company: Sutherland Location: Manikonda Job Description: Sutherland is seeking a skilled and experienced AR Caller / RCM Specialist to join our dynamic healthcare team. If you have a strong understanding of Physician Billing, CMS 1500, and Denial Management, this is the perfect opportunity to advance your career with a global leader in business process transformation. Key Responsibilities: Review and resolve denied claims, ensuring timely follow-up with insurance providers. Work on CMS 1500 claim submissions, corrections, and reprocessing. Identify and analyze denials, take necessary actions, and resubmit claims as needed. Apply knowledge of Modifiers, Hoopa Guidelines, and insurance policies to maximize reimbursements. Handle AR follow-ups and maintain accurate documentation of interactions. Collaborate with internal teams to enhance billing processes and reduce denials. Meet productivity and quality benchmarks set by the company. Required Skills & Qualifications: Minimum 12 months of experience in CMS 1500 claims processing. Strong expertise in Denial Management and AR calling. Familiarity with Physician Billing, Modifiers, and Hoopa Guidelines. Excellent communication and negotiation skills. Ability to work in a fast-paced, target-driven environment. Any Undergraduate/Graduate degree. What We Offer: Competitive Salary Package Rotational Night Shifts Transportation Facilities Comprehensive Benefits Package Career Growth & Development Opportunities Join Sutherland and be part of an innovative team driving excellence in healthcare revenue cycle managementsponsibilities Preferred candidate profile Perks and benefits