The Senior Executive – RCM is responsible for end-to-end revenue cycle operations, with a solid focus on charge posting, reconciliation, and overall production activities including charge posting, accounts receivable (AR), and patient statements.

The role ensures timely and accurate payment processing, high-quality output, SLA adherence, and efficient handling of clarifications, while supporting departmental KPIs and client expectations.

Genaral Responsibilities

- Manage medical billing process from submission to payment posting.
- Ensure timely claims processing with accuracy and efficiency.
- Oversee charge posting, denial management, and RCM compliance
- Key Responsibilities
- 1. Payment Posting & Reconciliation

- • Post payments received via ERA/EFT and manual methods accurately within defined TAT:
- o ERAs within 8 hours
- o Manual payments within 16 hours
- • Review and process clearinghouse files, scanned documents, and correspondence.
- • Perform payment reconciliation by comparing clearinghouse data with internal systems.
- • Identify and resolve discrepancies in payments, adjustments, and balances.
- • Prioritize patient payments and notify clients accordingly.
- • Monitor payment flows and escalate deviations or issues promptly.
- 1. Production & RCM Operations

- • Achieve 100% daily production targets across:
- o Payment posting
- o Charge posting
- o AR follow-ups (denials, no response)
- o Patient statements
- • Ensure >99% accuracy in all transactions with minimal errors.
- • Meet or exceed SLA adherence of >98% for all deliverables.
- • Process and reconcile all RCM activities within defined timelines.
- • Ensure completion of all assigned tasks within SLA and quality benchmarks.
- 1. Clarifications & Communication

- • Track, review, and resolve payment clarifications within TAT.




- • Manage and respond to emails and tickets promptly.
- • Coordinate with internal teams for clarification closure.
- • Maintain regular communication with Team Leads and Managers on payment and production status.
- • Provide End-of-Day (EOD) updates and escalation reports.
- 1. Quality & Compliance

- • Maintain 98% quality in payment posting and >99% overall transaction accuracy.
- • Adhere strictly to HIPAA, ISMS, QMS, and organizational SOPs.
- • Follow client-specific guidelines and workflows
- • Participate in error correction, rework reduction, and quality improvement initiatives.
- • Ensure audit readiness with accurate and compliant documentation.
- 1. Accounts Receivable & Issue Resolution

- • Work on AR tasks including denials, follow-ups, and unresolved accounts.
- • Escalate critical issues such as global denials or payment discrepancies.
- • Support resolution of overpayments and reconciliation gaps.
- • Collaborate with relevant teams to close open items efficiently.
- 1. Reporting & Performance Tracking

- • Track and update daily production metrics
- • Share payment and production status reports with stakeholders.
- • Perform weekly and monthly reconciliation reviews across all sources.
- • Consolidate and report clarification trends and performance insights.
- • Contribute to KPI tracking and performance reviews.
- 1. Process Improvement & Team Support

- • Identify process gaps and support automation and efficiency improvements.
- • Review workflows and ensure adherence to process checklists.
- • Provide cross-training and knowledge sharing within the team.
- • Adapt to process changes, system upgrades, and client requirements.
- Interested candidates please share your CV’s @[email protected] or contact purushothuman at (phone hidden) .

📌 RCM executive (Chennai)
🏢 Virtueus Healthcare Services
📍 Chennai