Role Summary

We are seeking a seasoned, highly organized Senior Revenue Cycle Specialist to join our SWAT / Level 3 (L-3) support team — the most senior tier of our revenue cycle operation. This team owns the resolution of complex, escalated billing issues across the entire client base, including accounts served by both our internal billing teams and our outsourcing (BPO) partners. The right person is a true problem-solver: someone who can take a tangled, high-stakes claims or setup issue, perform a disciplined root cause analysis, drive it to resolution across multiple teams, and document a repeatable fix so it does not happen again.

Key Responsibilities

Escalation Management & Root Cause Analysis

- Serve as a senior point of resolution for escalated, complex, and high-dollar billing issues routed from internal billing teams, BPO partners, support/help desk, retention, and client-facing staff.- Identify and capture all affected claims and accounts when a systemic issue is found, and drive corrective action end-to-end through to verified resolution.
- Document findings clearly and present recommendations and corrective-action plans to team leads and leadership.

Cross-Functional Coordination & Communication

- Partner daily with multiple teams — internal billing, BPO partners, Enrollment, Credentialing, Portals, QA, Data Entry, Onboarding, and Retention — to resolve issues that span team boundaries.
- Own and manage hand-offs between functions (for example, credentialing-completion to enrollment-initiation to system updates), ensuring tasks are routed, tracked, and closed correctly.
- Communicate status, blockers, and resolutions proactively and professionally so that no issue becomes invisible work.

Account Setup, Configuration & Workflow Execution





- Execute and verify account setup and configuration changes, including current-client billing setup, in-house (IH) and full-service (FS) conversions, service-facility and demographic updates, and payer/plan additions.
- Initiate and confirm EDI/ERA enrollment and related setup steps, coordinating with the Enrollment team and following established checklists and SOPs.
- Validate that changes produce the intended downstream result (clean claim submission, correct adjudication, accurate posting).

Subject Matter Expertise, SOPs & Process Improvement - Author, refine, and maintain Standard Operating Procedures (SOPs) and training materials based on issues resolved, helping standardize how the team works.

- Continuously look for ways to eliminate manual steps, reduce repeat issues, and improve efficiency — including through automation and AI-assisted workflows where appropriate.

Client & Executive-Level Communication

- Communicate efficiently and professionally with clients (practices and their staff) on escalated matters, representing the organization with a polished, credible, client-ready presence.
- Prepare and deliver clear written and verbal updates to executive leadership, translating detailed billing findings into concise, decision-ready summaries.

Performance, Productivity & Quality

- Manage a high volume of concurrent tasks against productivity and completion-rate targets without sacrificing accuracy.




- Support and help move key revenue cycle metrics in the right direction — for example net collection rate (NCR), aged AR (AR > 120 days), denial rate, and first-pass resolution — through faster, cleaner issue resolution.
- Maintain meticulous documentation and notes so that every action is traceable and auditable.

Required Qualifications

- 5+ years' billing experience. Minimum five (5) years in a fast-paced, high-volume medical billing / revenue cycle role.
- Proven multitasking ability. Demonstrated success managing many concurrent priorities and escalations at once, under time pressure, without dropping details.
- Detailed root cause analysis. A track record of diagnosing the underlying cause of billing problems and resolving them at the source — not just clearing the symptom.
- Strong cross-team collaboration. Ability to work well with, and communicate effectively across, multiple teams and stakeholders.
- Multiple billing systems. Working knowledge of more than one billing / practice-management / RCM system, with the ability to learn new platforms quickly.
- Professional, client-ready communication. A professional appearance and presence, with the ability to communicate with clients efficiently, clearly, and with credibility.
- Fluent English. Fluency in spoken and written English.
- Excellent organizational skills. Highly organized, detail-oriented, and disciplined about documentation and follow-through.
- Executive communication experience. Experience communicating and interacting directly with executive leadership.
- Subject matter expert. Able to serve as an SME and trusted escalation resource for others.
- Fast learner. Picks up new systems, payer rules, and processes quickly and independently.
- Flexible availab

📌 Senior Revenue Cycle Specialist - Work From Home (Jaipur)
🏢 ClinicMind
📍 Jaipur