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auditor specialist revenue cycle management rcm

Meds IT Nexus

Position Title: Auditor Specialist &ndash; Revenue Cycle Management (RCM)Department: Medical Billing &amp; CredentialingLocation: RawalpindiCompany: Meds NexusJob Overview The Auditor Specialist for Revenue Cycle Management (RCM) is responsible for overseeing the auditing processes within the medical billing and credentialing functions. The role involves conducting detailed audits, ensuring compliance with regulations, identifying areas for improvement, and implementing corrective actions to optimize revenue cycle performance. The auditor will mentor team members, provide consulting services, manage risks, and collaborate closely with operations and billing teams to enhance the RCM process.Key Responsibilities1. Audit Planning and Execution:- Develop and implement comprehensive audit plans for medical billing and credentialing processes.- Conduct regular audits on charge entries, payment postings, and claim submissions to ensure compliance with industry standards and company policies.- Review coding practices and billing procedures to ensure accuracy in documentation and claims.2. Compliance and Regulatory Adherence:- Ensure all billing and credentialing activities comply with relevant regulations (HIPAA, CMS guidelines, etc.).- Monitor for adherence to payer-specific billing rules and government regulations.- Stay updated on changes in healthcare laws and ensure the team is compliant.3. Consulting and Mentorship:- Serve as a role model and mentor to less experienced personnel on professional standards of performance.- Provide consulting services and lead independent audits and assessments to improve operations and manage risks related to complex technology and processes.- Mentor, train, and enhance the knowledge of Senior/Staff Auditors and other business area teams in auditing and RCM processes.4. Performance Analysis and Reporting:- Analyze audit findings to identify trends, issues, and areas for improvement in the RCM process.- Provide detailed reports on audit outcomes to the HOD Operations, outlining key performance indicators (KPIs), compliance issues, and recommendations for improvement.- Ensure the preparation and delivery of KPI &amp; MTD (Month to Date) reports to track performance, which will directly influence bonuses and incentives for team members.- Work closely with teams to resolve discrepancies and implement solutions to enhance revenue cycle efficiency.5. Follow-up and Remediation:- Follow up on past audit findings to ensure timely and adequate remediation.- Implement corrective action plans based on audit outcomes to enhance overall compliance and financial performance.6. Risk Management and Quality Control:- Identify and mitigate risks associated with the revenue cycle by ensuring strict compliance and best practices in billing and credentialing.- Conduct regular risk assessments and recommend strategies to minimize financial losses or compliance violations.7. Continuous Improvement:- Recommend process improvements to optimize the revenue cycle workflow and enhance operational efficiency.- Lead efforts to implement automation and advanced technology solutions for RCM auditing.- Track performance metrics and recommend actions for improved revenue capture and reduced denials.Qualifications and Skills Education:- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field (required).- Certification in Medical Billing/Coding, RCM, or relevant certifications (e.g., CPC, CPMA) preferred.Experience: - 5+ years of experience in medical billing, credentialing, and RCM auditing, with leadership experience preferred.- Minimum 5 years of full-time working experience in auditing or quality management in RCM or healthcare.Skills: - Knowledge of ISO standards (ISO 9001, ISO 27001) and audit procedures.- Advanced knowledge of Quality Methods, Risk Management, and relevant ISO certifications (ISO 14064-1 experience is an advantage).- Proficiency in billing and auditing software tools (e.g., Epic, Cerner, Kareo, etc.).- Excellent analytical, organizational, and mentoring skills.- Strong communication and leadership abilities.- Professional and mature attitude with the ability to work in fast-paced, dynamic environments.Job Rewards and Benefits:- Paid Leaves- HR Bonus- Loan Policy- Advance Salary- Yearly Loyalty Rewards- Performance-based Bonuses (based on KPI &amp; MTD reports)- Leave Encashment- Inflation Bonus- Promotion- Increments- Medical (TBD)- Employee Contributory Saving Plan- Saturday and Sunday Off- Complimentary Food (Dinner) &amp; Tea/Green Tea (Two times)Job Type: Full-timeWork Location: In person

Auditor Specialist – Revenue Cycle Management (RCM)

Revmed

Sr. Sales Lead &ndash; Medical Billing ServicesCompany: REVMED &ndash; Medical Billing &amp; Revenue Cycle Management Location: 5th Road, Rawalpindi Job Type: Full-Time (Onsite)Position OverviewREVMED is seeking a results-driven Sales Lead &ndash; Medical Billing Services to drive new business growth in the US healthcare market. This role is responsible for generating qualified leads, nurturing prospects, and supporting the complete sales cycle from initial outreach to deal closure.The ideal candidate will help expand REVMED&rsquo;s client base of physician practices, specialty clinics, ambulatory surgery centers, and hospitals by promoting our Medical Billing, Revenue Cycle Management (RCM), and Coding, Credentialing, and Accounts Receivable (AR) services.This role serves as a key bridge between marketing and sales, ensuring consistent pipeline generation and revenue growth.Key ResponsibilitiesLead Generation &amp; Prospecting<ul><li>Generate qualified leads through cold calling, email campaigns, LinkedIn outreach, referrals, and industry networking</li><li>Identify physician practices, specialty clinics, ambulatory centers, and hospitals as potential clients</li><li>Research prospects to understand billing challenges and identify decision-makers</li><li>Maintain consistent outbound prospecting activity to build a strong sales pipeline</li></ul>Lead Qualification &amp; Pipeline Management<ul><li>Qualify leads based on service need, authority, budget, and timeline</li><li>Schedule discovery calls and meetings for senior sales leadership</li><li>Maintain accurate CRM records (Salesforce, HubSpot, or similar)</li><li>Conduct regular follow-ups to nurture and convert prospects</li></ul>Client Communication &amp; Presentation Support<ul><li>Conduct introductory calls and present REVMED&rsquo;s medical billing &amp; RCM services</li><li>Share company profile, proposals, and service details</li><li>Assist in preparing customized proposals and presentations</li><li>Support negotiation and closing processes</li></ul>Market Research &amp; Strategy Support<ul><li>Monitor trends in US healthcare, medical billing, and insurance regulations</li><li>Identify new target specialties and market segments</li><li>Provide feedback to management regarding competition and demand</li></ul>QualificationsEducation<ul><li>Bachelor&rsquo;s degree in Business, Marketing, Healthcare Management, or related field</li></ul>Experience<ul><li>2&ndash;5 years of B2B sales experience</li><li>Preferably in Medical Billing, Healthcare Services, or Revenue Cycle Management</li><li>Proven experience in outbound sales and lead generation</li></ul>Skills<ul><li>Strong communication and persuasion skills</li><li>Confidence in cold calling and prospect outreach</li><li>Basic understanding of US medical billing and insurance processes</li><li>CRM proficiency</li><li>Strong organizational and time management skills</li></ul>Preferred Competencies<ul><li>Understanding of US healthcare insurance and revenue cycle processes</li><li>Experience selling services to physician practices or clinics</li><li>Self-motivated and target-driven mindset</li><li>Ability to work independently and within a team</li></ul>Compensation &amp; BenefitsSalary: PKR 150,000 &ndash; 250,000 per monthAdditional Benefits<ul><li>Family Health Insurance up to PKR 900,000</li><li>Handsome commission on sales</li><li>36 Paid Leaves annually</li><li>Leave Encashment</li><li>Annual Increment</li><li>Promotion-Based Increment</li><li>Retention Bonus</li><li>Professional Growth Opportunities into Sales Manager / Business Development roles</li><li>Training in Medical Billing &amp; RCM Services</li></ul>Pay: Rs150,000.00 - Rs250,000.00 per monthWork Location: In person

Senior Sales Lead – Medical Billing Services

Arthur Lawrence

Medical Coder &ndash; Freestanding Emergency Room (FSER)Department: Precision Hub Industry: Revenue Cycle Management (RCM) Employment Type: Full-TimeAbout UsPrecision Hub is a technology-driven Revenue Cycle Management (RCM) consulting firm specializing in analytics, process optimization, and healthcare technology solutions. We are committed to delivering accuracy, compliance, and financial performance improvement for our healthcare partners.Position OverviewWe are seeking detail-oriented and experienced Medical Coders with Freestanding Emergency Room (FSER) experience to join our growing team. The ideal candidate will be responsible for reviewing and analyzing medical documentation, assigning accurate codes, and ensuring compliance with CMS regulations and payer guidelines.Key Responsibilities<ul><li>Review medical records and documentation for completeness and accuracy</li><li>Assign appropriate ICD-10-CM, CPT, and HCPCS codes for FSER services</li><li>Ensure compliance with CMS regulations and payer-specific guidelines</li><li>Identify, investigate, and resolve coding discrepancies</li><li>Support billing accuracy and optimal reimbursement</li><li>Maintain productivity and quality standards</li><li>Stay updated on coding regulations, industry changes, and compliance requirements</li></ul>Qualifications<ul><li>Proven experience in Medical Coding, specifically Freestanding Emergency Room (FSER) coding</li><li>Strong understanding of CMS guidelines, payer policies, and audit/compliance processes</li><li>Proficiency in ICD-10-CM, CPT, and HCPCS coding systems</li><li>Excellent attention to detail and analytical skills</li><li>Strong communication and problem-solving abilities</li><li>Professional coding certification required (CPC, CCS, or equivalent preferred)</li></ul>Preferred Skills<ul><li>Experience working in an RCM environment</li><li>Ability to manage high-volume coding tasks while maintaining accuracy</li><li>Familiarity with coding audits and denial management</li></ul>Benefits &amp; Perks<ul><li>IPD, OPD Health Coverage &amp; Life Insurance</li><li>Monthly Performance Bonus</li><li>Provident Fund &amp; EOBI</li><li>Gym &amp; Transportation Allowance</li><li>Casual, Sick &amp; U.S. Holidays</li><li>Annual &amp; Paternity Leaves</li></ul>How to ApplyInterested candidates are encouraged to apply through Indeed or submit their CV to: sibgha.munis@arthurlawrence.netJob Type: Full-timeWork Location: In person

Medical Coder

Speak Viral

We are seeking a results-driven Medical Billing Sales Executive to promote and sell medical billing services to healthcare providers, clinics, hospitals, and physician practices. The ideal candidate will be responsible for identifying new business opportunities, building relationships with healthcare professionals, and demonstrating how medical billing solutions can improve revenue cycle management and operational efficiency.Key Responsibilities<ul><li>Identify and prospect potential clients such as physician practices, clinics, hospitals, and healthcare groups.</li><li>Promote and sell medical billing and revenue cycle management (RCM) services.</li><li>Conduct sales presentations and product demonstrations to healthcare decision-makers.</li><li>Generate and qualify leads through cold calling, networking, referrals, and digital outreach.</li><li>Build and maintain strong relationships with healthcare providers and administrators.</li><li>Understand client billing challenges and propose appropriate billing solutions.</li><li>Prepare proposals, negotiate contracts, and close sales deals.</li><li>Achieve monthly and quarterly sales targets.</li><li>Maintain accurate records of sales activities and client interactions in CRM systems.</li><li>Coordinate with operations and billing teams to ensure smooth onboarding of new clients.</li><li>Stay updated on healthcare billing regulations, insurance processes, and industry trends.</li></ul>Required Skills &amp; Qualifications<ul><li>Bachelor&rsquo;s degree in Business, Healthcare Administration, Marketing, or a related field (preferred).</li><li>2+ years of experience in healthcare sales, medical billing sales, or healthcare services sales.</li><li>Strong knowledge of medical billing processes, insurance claims, and revenue cycle management (RCM).</li><li>Excellent communication, negotiation, and presentation skills.</li><li>Ability to build relationships with healthcare professionals and decision-makers.</li><li>Strong prospecting and lead generation skills.</li><li>Experience using CRM tools and sales tracking systems.</li><li>Self-motivated with a strong focus on achieving sales goals.</li></ul>Job Type: Full-timePay: Rs60,000.00 - Rs90,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(6pm to 3am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Medical Billing Sales Executive

Exciting Opportunity: Team Lead RCM Operations at Meds Nexus PVT. Ltd.About Us: Meds Nexus PVT. Ltd. is at the forefront of the medical billing and healthcare industry, dedicated to delivering top-notch services to our clients. We pride ourselves on maintaining the highest standards of efficiency, compliance, and innovation. We are currently seeking a talented and driven Team Lead RCM Operations to join our dynamic team.Position Overview: As the Team Lead RCM Operations, you will play a crucial role in managing and guiding a team of Medical Billing Associates. You will be responsible for ensuring the accuracy and efficiency of the revenue cycle management process, from medical coding to claims submissions and payment posting. This is an excellent opportunity for a motivated individual to contribute to our mission and grow within a leading organization.Key Responsibilities:<ul><li>Supervise and mentor a team of Medical Billing Associates, ensuring high performance and adherence to protocols.</li><li>Oversee the end-to-end revenue cycle management process, including medical coding, charge entry, claims submissions, payment posting, and follow-up.</li><li>Conduct regular team meetings to provide updates, address issues, and ensure smooth operations.</li><li>Monitor team performance metrics and implement improvement plans as needed.</li><li>Ensure compliance with federal and state regulations in all billing operations.</li><li>Develop and implement training programs for new hires and existing staff to enhance their skills and knowledge.</li><li>Review operational data to identify trends and areas for improvement, making recommendations to Asst. Manager or Manager Operations.</li></ul>Skills and Qualifications:<ul><li>Strong knowledge of RCM processes and best practices.</li><li>Excellent leadership and team management skills.</li><li>Effective communication and interpersonal abilities.</li><li>Proficiency in conflict resolution and problem-solving.</li><li>Strong analytical and data interpretation skills.</li><li>Experience with medical billing software and tools.</li><li>High attention to detail and accuracy.</li><li>Ability to work in a fast-paced environment and meet deadlines.</li></ul>Job Details:<ul><li>Industry: Healthcare/Medical Billing</li><li>Functional Area: Operations</li><li>Job Shift: Night Shift (First Shift)</li><li>Job Type: Full Time/Permanent</li><li>Job Location: Islamabad, Rawalpindi, Pakistan</li><li>Gender: Open to all</li><li>Minimum Education: Bachelor's Degree</li><li>Preferred Education: BBA/MBA/BSCS/BS/M.Sc/MS or related field</li><li>Career Level: Team Lead</li><li>Minimum Experience: 3+ Years in RCM operations with at least 1-2 years in a supervisory role</li></ul>Job Rewards and Benefits:<ul><li>Paid Leaves</li><li>HR Bonus</li><li>Inflation Bonus</li><li>Promotion</li><li>Increments</li><li>Medical (TBD)</li><li>Saving contribution plan (CSP)</li><li>Saturday and Sunday Off</li><li>Transportation allowances only for female staff</li><li>Complementary Food (Dinner) &amp; Tea/Green Tea (Two times)</li><li>Job Location:</li><li>Office # 1st, 5th Floor, Gold Mark Plaza, Asghar Mall Rd, Asghar Mall Scheme, Rawalpindi, Punjab 46000</li><li>Job Timing:</li><li>05:30 PM To 02:30 AM</li><li>Special Note:</li><li>This job is not for fresh candidates.</li></ul>Why Join Us:<ul><li>Be a part of a leading and innovative organization in the healthcare industry.</li><li>Opportunities for professional growth and development.</li><li>Collaborative and supportive work environment.</li><li>Competitive salary and benefits package.</li></ul>Job Type: Full-timeWork Location: In person

Team Lead RCM Operations

Job Summary:We are seeking a detail-oriented and experienced Medical Credentialing &amp; Enrollment Specialist to manage provider credentialing, re-credentialing, and payer enrollment processes. The ideal candidate will ensure compliance with insurance and regulatory requirements while maintaining accurate provider records and timely submissions.Key Responsibilities:<ul><li>Manage end-to-end provider credentialing and enrollment with insurance payers (Medicare, Medicaid, Commercial Plans).</li><li>Prepare and submit initial credentialing and re-credentialing applications.</li><li>Maintain and update provider information in CAQH (Council for Affordable Quality Healthcare).</li><li>Track application status and follow up with payers to ensure timely approvals.</li><li>Handle provider enrollment, revalidation, and demographic updates.</li><li>Maintain accurate records of provider credentials, licenses, certifications, and expirations.</li><li>Coordinate with internal departments (billing, HR, compliance) for required documentation.</li><li>Resolve credentialing-related issues and payer denials.</li><li>Ensure compliance with healthcare regulations and payer requirements.</li><li>Maintain credentialing database and prepare reports as required.</li></ul>Requirements:<ul><li>Bachelor&rsquo;s degree or relevant experience in Healthcare Administration or related field.</li><li>1&ndash;3+ years of experience in US medical credentialing and enrollment.</li><li>Hands-on experience with CAQH, PECOS, NPPES, and payer portals.</li><li>Strong knowledge of Medicare, Medicaid, and commercial insurance processes.</li><li>Excellent communication and follow-up skills.</li><li>Strong attention to detail and organizational skills.</li><li>Ability to handle multiple providers and deadlines simultaneously.</li></ul>Preferred Skills:<ul><li>Experience in RCM (Revenue Cycle Management) environment.</li><li>Familiarity with credentialing software/tools.</li><li>Knowledge of compliance and healthcare regulations.</li><li>Ability to work independently and in a team environment.</li></ul>Benefits (Customize as per your company):<ul><li>Competitive Salary Package</li><li>Post-Probation &amp; Annual Increments</li><li>Family Health Insurance</li><li>Paid Leaves &amp; Leave Encashment</li><li>Performance &amp; Retention Bonuses</li><li>Meal Allowance</li><li>Pick &amp; Drop (for female staff)</li></ul>Job Type: Full-timeWork Location: In person

Medical Credentialing & Enrollment Specialists

MaxRemind

MaxRemind is seeking a dynamic and motivated Business Development &amp; Sales Support Specialist to join our growing team. The ideal candidate will play a key role in supporting the sales cycle, managing client interactions, and contributing to business growth within the US healthcare industry. This role requires strong communication skills, familiarity with EHR and billing software, and the ability to manage multiple sales-related activities efficiently.Key Responsibilities:<ul><li>Deliver product demonstrations of Billing Software, EHR, and RCM solutions to prospective clients.</li><li>Manage the preparation of proposals, pricing structures, and service contracts.</li><li>Coordinate and support the client onboarding process.</li><li>Handle inbound leads and schedule product demonstrations with potential clients.</li><li>Assist the sales team in converting leads into long-term clients.</li><li>Maintain accurate and updated records in the CRM system.</li><li>Collaborate with the marketing team to align sales and lead-generation strategies.</li><li>Build and maintain strong relationships with clients to ensure customer satisfaction.</li></ul>Requirements:<ul><li>Strong knowledge and understanding of EHR and Billing software.</li><li>Excellent communication, negotiation, and presentation skills.</li><li>Minimum 2+ years of experience in a similar role or within the US healthcare industry.</li><li>Bachelor&rsquo;s degree in Business Administration, Healthcare Management, or a related field (Master&rsquo;s degree preferred).</li><li>Ability to work in a fast-paced and target-driven environment.</li><li>Strong organizational and problem-solving skills.</li><li>Flexibility to work evening shifts (5:00 PM &ndash; 2:00 AM).</li></ul>What We Offer:<ul><li>Competitive salary package.</li><li>Dinner and tea provided during evening shifts.</li><li>A supportive and collaborative work environment.</li><li>Opportunities for professional development and career growth.</li></ul>Send your resume to: hr@mremind.com Location: Rawalpindi Job Type: Full-time (On-site)Pay: Rs70,000.00 - Rs200,000.00 per monthWork Location: In person

Business Development & Sales Support Specialist

Explore 187+ Auditor specialist revenue cycle management rcm in Rawalpindi this March. Find roles across top companies and apply now to boost your career.