RCM Specialist

Role Overview: As a Revenue Cycle Management (RCM) Specialist at CapMinds, your primary responsibility will be to manage and optimize the complete revenue cycle. You will ensure accuracy, compliance, and efficiency across all RCM operations, leveraging your 45 years of proven expertise in end-to-end RCM within the healthcare industry. Key Responsibilities: - Review patient accounts to ensure accurate ICD-10, CPT, and HCPCS coding, along with compliant billing practices. - Investigate and resolve denied or rejected claims, coordinating timely resubmissions to minimize revenue loss. - Collaborate with clinical teams to ensure documentation accurately supports coding and billing requirements. - Optimize RCM processes to reduce denials, improve cash flow, and accelerate collections. - Prepare and present reports on billing performance, AR aging, and key revenue metrics. - Identify and implement workflow improvements to drive efficiency and maximize revenue. Qualifications Required: - 45 years of proven experience in end-to-end RCM within the healthcare industry. - Strong knowledge of ICD-10, CPT, and HCPCS coding standards. - Hands-on experience with EMR/EHR systems and billing software. - Excellent analytical, organizational, and problem-solving abilities. - Expertise in insurance verification, claim submission, denial management, and AR follow-up. Role Overview: As a Revenue Cycle Management (RCM) Specialist at CapMinds, your primary responsibility will be to manage and optimize the complete revenue cycle. You will ensure accuracy, compliance, and efficiency across all RCM operations, leveraging your 45 years of proven expertise in end-to-end RCM within the healthcare industry. Key Responsibilities: - Review patient accounts to ensure accurate ICD-10, CPT, and HCPCS coding, along with compliant billing practices. - Investigate and resolve denied or rejected claims, coordinating timely resubmissions to minimize revenue loss. - Collaborate with clinical teams to ensure documentation accurately supports coding and billing requirements. - Optimize RCM processes to reduce denials, improve cash flow, and accelerate collections. - Prepare and present reports on billing performance, AR aging, and key revenue metrics. - Identify and implement workflow improvements to drive efficiency and maximize revenue. Qualifications Required: - 45 years of proven experience in end-to-end RCM within the healthcare industry. - Strong knowledge of ICD-10, CPT, and HCPCS coding standards. - Hands-on experience with EMR/EHR systems and billing software. - Excellent analytical, organizational, and problem-solving abilities. - Expertise in insurance verification, claim submission, denial management, and AR follow-up.