RCM Specialist

Job Title:

RCM / Medical Billing Specialist

Schedule:

5 Days a Week | Rotational Shifts | Rotational Week Off

Experience:

3 - 6 Years

Role Overview

We are looking for experienced professionals with

hands-on expertise in U.S.

Healthcare Revenue Cycle Management (RCM)

and

medical billing troubleshooting

.The ideal candidate should have strong analytical skills, deep domain knowledge, andthe ability to resolve complex claim, posting, or configuration issues across multiplebilling systems.This is a

technical and analytical RCM support role

ideal for those who go beyondbasic AR follow-up or call-center responsibilities to identify and fix

systemic billing

issues

.

Key Responsibilities

Provide Level 1 and Level 2 support for RCM workflows, including claimsubmission, charge entry, payment posting, and denial management.Troubleshoot payer rejections, configuration errors, and ERA postingdiscrepancies.Analyze

EDI 835/837

transaction data to identify and resolve logic ormapping issues.Collaborate with clearinghouses (Waystar, Availity, Change Healthcare) toaddress payer-related discrepancies.Document recurring issues, perform root cause analysis, and work withinternal teams to prevent recurrence.Communicate effectively with U.S. clients, ensuring clear, solution-orientedupdates and documentation.Maintain compliance with

HIPAA

and

42 CFR Part 2

guidelines whilehandling sensitive data.

Required Skills s Domain Expertise

Strong understanding of

U.S. Healthcare RCM

including charge entry,payment posting, denial analysis, and AR follow-up.In-depth knowledge of

payer rules

(Medicare, Medicaid, commercialpayers).Working knowledge of

CPT, ICD-10, HCPCS, modifiers

, and

ERA/EDI 835-

837

transactions.Demonstrated ability to identify

root causes

behind denials and system-levelbilling issues.

Technical Competencies

Hands-on Experience With One Or More Medical Billing Systems

CollaborateMD, Kareo, AdvancedMD, Athenahealth, eClinicalWorks,
DrChrono, NextGen, PracticeSuite, or similar.Experience using

clearinghouse portals

such as Waystar, Availity, andChange Healthcare.Familiarity with

ticketing tools

like Zendesk, Freshdesk, or SalesforceService Cloud.Strong

Excel

skills for reporting, validation, and analysis (pivot tables,lookups).

Customer Support Competencies

Analytical thinker who investigates workflow issues instead of surface-levelresolutions.Excellent written and verbal communication skills tailored for non-technicalaudiences.Ability to collaborate with internal product or development teams fortechnical fixes and process improvements.Proven record of maintaining high CSAT scores and quick response times.

Qualifications

Bachelor’s

Degree

(preferably in Commerce, Healthcare Administration, orrelated field).

3

-

6 years

of relevant experience in U.S. Healthcare RCM.

Certifications preferred:

HIPAA Awareness, AAPC CPC (in progress orcompleted).