Job Summary:
Responsible for managing the hospital revenue cycle process, including billing, insurance/TPA claims, accounts receivable, payment follow-up, and denial management to ensure timely revenue realization.
Key Responsibilities:
- Manage end-to-end RCM activities including billing, claims submission and payment posting.
- Coordinate with TPA/insurance companies for cashless approvals and claim processing.
- Follow up on outstanding accounts receivable and pending claims.
- Identify and resolve claim denials, rejections and billing discrepancies.
- Coordinate with IP Billing, Finance, Insurance and Clinical teams for issue resolution.
- Maintain accurate billing, claims and payment records.
- Prepare RCM/AR reports and track pending and rejected claims.
- Ensure compliance with hospital billing policies and insurance/TPA requirements.
Qualification: Graduate in any discipline; healthcare/hospital billing certification preferred.
Experience: 2–5 years of experience in Hospital RCM, Medical Billing, Insurance/TPA or AR operations.