Qureos Mentor

AppsGenii Technologies (Pvt.) Ltd.

We are looking for a Senior RCM &amp; Claims Denial Handler to join our Reclaim team. The ideal candidate will have strong experience in US healthcare billing, claims, AR follow-up, and denial management. This role requires expertise in identifying the root causes of denials, resolving claim rejections, and implementing corrective actions to maximize revenue recovery.Key Responsibilities:<ul><li>Manage and oversee end-to-end RCM processes including charge entry, payment posting, claims submission, AR follow-up, and denial resolution.</li><li>Analyze denied and rejected claims to identify trends, root causes, and process gaps.</li><li>Handle claim appeals and resubmissions efficiently while ensuring compliance with payer guidelines and timelines.</li><li>Collaborate with payers and insurance representatives to resolve issues promptly.</li><li>Review and interpret EOBs (Explanation of Benefits) and payer responses to ensure accurate posting and reconciliation.</li><li>Monitor aging reports and take proactive steps to reduce AR days.</li><li>Train and mentor junior RCM team members on denial handling processes and best practices.</li><li>Work closely with the coding, billing, and compliance teams to minimize future denials.</li><li>Generate and present performance and denial trend reports to management.</li><li>Ensure adherence to HIPAA and all applicable federal and state regulations.</li></ul>Required Skills &amp; Qualifications:<ul><li>Bachelor&rsquo;s degree in Healthcare Administration, Business, or related field.</li><li>5+ years of experience in RCM operations with a strong focus on claims denial management.</li><li>In-depth knowledge of US healthcare billing, CPT, ICD-10, and HCPCS codes.</li><li>Hands-on experience with medical billing software and clearinghouses (e.g., Kareo, Athena, AdvancedMD, eClinicalWorks, or similar).</li><li>Strong analytical, problem-solving, and communication skills.</li><li>Ability to multitask, manage priorities, and meet deadlines in a fast-paced environment.</li><li>High attention to detail with a commitment to accuracy and quality.</li></ul>Preferred Qualifications:<ul><li>Certification in CPB, CPC, or RCM is a plus.</li><li>Prior experience working with US-based healthcare providers or BPO firms.</li><li>Proven track record of improving first-pass claim rates and reducing denial ratios.</li></ul>Why Join Us:<ul><li>Competitive salary and performance-based bonuses.</li><li>Exposure to international clients and advanced healthcare systems.</li><li>Opportunity to lead and mentor a growing team of professionals.</li><li>Supportive environment that values continuous learning and process excellence.</li></ul>Job Type: Full-timePay: Rs15,000.00 - Rs200,000.00 per monthWork Location: In person

Senior RCM & Claims Denial Handler

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AppsGenii Technologies (Pvt.) Ltd.

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Senior RCM & Claims Denial Handler