RCM Specialist

Location: Lahore (Remote)
Shift Timing: 6:00 PM – 3:00 AM (Pakistan Standard Time)
Employment Type: Full-time

Key Responsibilities

• Perform Verification of Benefits (VOBs) to confirm insurance eligibility and coverage.
• Accurately manage payment posting for payers and patients.
• Handle Accounts Receivable (AR) by following up on outstanding claims and reducing aging.
• Manage denials and rejections, identify root causes, and ensure timely resolution.
• Prepare and submit appeals with supporting documentation and follow up as needed.
• Process billing for Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) services.
• Collaborate with providers, internal teams, and insurance companies to ensure smooth claim processing.
• Maintain accurate and up-to-date records in RCM systems.
• Use tools such as Tebra, 8x8, Trizetto, and others to enhance workflow efficiency.

Required Skills & Qualifications

• 3–5 years of experience in medical billing or RCM operations.
• Strong understanding of insurance workflows (VOBs, AR, denials, appeals).
• Familiarity with RPM and CCM billing guidelines.
• Basic proficiency in MS Excel (sorting, filtering, formulas).
• Hands-on experience with platforms such as Tebra, Trizetto, and 8x8.

Preferred Qualifications

• Experience with Electronic Health Record (EHR) systems.
• Knowledge of HIPAA compliance and medical billing standards.
• Certification in medical billing or coding (CPC, CPB) is a plus.

Job Type: Full-time

Work Location: Remote