RCM Specialist- US Health Care

Job Summary:
The RCM (Revenue Cycle Management) Specialist is responsible for managing end-to-end billing, claims processing, payment posting, and denial management to ensure accurate and timely reimbursement. This role supports healthcare providers, administrative teams, and patients by ensuring clean claim submission, resolving billing discrepancies, and maintaining compliance with regulatory and payer guidelines.

Key Responsibilities:

· Review patient demographic, insurance, and clinical documentation to ensure accurate claim creation and billing.
· Verify patient insurance eligibility, benefits, and coverage requirements prior to claim submission.
· Prepare, submit, and monitor medical claims to payers, ensuring timely and accurate processing.
· Investigate and resolve claim denials, rejections, and underpayments by coordinating with payers, providers, and internal teams.
· Ensure compliance with federal, state, and payer-specific billing regulations, including coding and HIPAA requirements.
· Maintain comprehensive and up-to-date records in practice management and EMR/RCM systems.
· Generate reports on claims status, collections, denials, and revenue performance.
· Support internal audits and quality improvement initiatives within the revenue cycle.
· Provide guidance to team members on billing guidelines, payer policies, and RCM best practices.

Qualifications:

· Bachelor’s degree in healthcare administration, business, life sciences, or related field preferred but not required.
· Prior experience in medical billing, RCM, claims processing, or health insurance is preferred.
· Strong understanding of medical billing practices, CPT/ICD coding, modifiers, and healthcare reimbursement workflows.
· Familiarity with EMR, EHR, and RCM/billing software systems.
· Excellent written and spoken English communication skills for interacting with patients, providers, and insurers.
· Strong attention to detail, accuracy, and organizational skills.
· Ability to maintain confidentiality and handle sensitive financial and medical information.

Key Competencies:

· Analytical thinking and problem-solving.
· Accuracy and attention to detail.
· Time management and multitasking.
· Interpersonal skills and professionalism.
· Strong English communication skills (C1) for documentation, correspondence, and payer interactions.

Timings: 7 PM to 4 AM Working Days: 5 Days a week

Benefits:· Weekly 2 days off · EOBI · Medical Life Insurance (IPD + OPD)

At Abacus, we’re not just a workplace; we’re a community built on core values. As advocates of diversity and inclusion, we proudly stand as an Equal Opportunity Employer, ensuring equitable opportunities for all. We uphold the highest standards of accountability, encouraging every team member to take ownership of their work and contribute to our shared goals. Collaboration is fundamental to our success; we believe in the power of teamwork. We foster a culture of continuous learning, where curiosity is celebrated, and growth is nurtured. Respect and empathy guide our interactions, and we embrace bold ideas and open dialogue, believing that innovation flourishes in an environment of openness.

Join us at Abacus, where our values not only define our work but also shape our identity as a community!

Job Type: Full-time
Work Location: In person (Lahore)

Job Type: Full-time

Pay: Rs100,000.00 - Rs130,000.00 per month

Work Location: In person