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auditor specialist – revenue cycle management (rcm)

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auditor specialist – revenue cycle management (rcm) Jobs in Rawalpindi

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team lead rcm operations

Meds IT Nexus

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

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)

Centrix

Business Development Executive &ndash; US Healthcare (females are encouraged to apply)Company: CentriixLocation: Bahria Town Phase 7, Rawalpindi (Onsite)Salary: 100k to 110k + commissionRole OverviewCentriix is looking for a driven Business Development Executive to generate new business opportunities in the U.S. healthcare market.The role involves cold calling, lead generation, appointment setting, and participating in closing deals with medical practices in the United States.Key Responsibilities<ul><li>Conduct outbound cold calls to U.S. cardiology and heart care practices</li><li>Identify decision-makers such as practice managers and physicians</li><li>Generate qualified leads and schedule meetings</li><li>Present Centriix services including medical billing, RCM, and healthcare support</li><li>Conduct discovery conversations to understand practice needs</li><li>Participate in sales calls and assist in closing deals</li><li>Maintain consistent follow-ups with prospects</li><li>Track leads, conversations, and opportunities in CRM</li><li>Meet weekly and monthly outreach and sales targets</li></ul>Requirements<ul><li>Cold calling experience is mandatory</li><li>Fluent English with a neutral/American accent</li><li>Experience speaking with U.S. clients preferred</li><li>Strong persuasion and objection-handling skills</li><li>Basic understanding of B2B sales and healthcare services</li><li>Self-motivated and target-driven</li></ul>⸻What We Offer<ul><li>Competitive base salary + performance commission</li><li>Opportunity to work with U.S. healthcare providers</li><li>Professional sales environment</li><li>Long-term growth opportunities</li></ul>Apply on whatsapp: 03347242418&hellip;&hellip;&hellip;&hellip;&hellip;..Job Type: Full-timePay: Rs100,000.00 - Rs110,000.00 per monthWork Location: In person

Business Development Executive

Job description:About Us: Meds Nexus PVT. Ltd. is a pioneer in the U.S. healthcare outsourcing industry, offering top-tier Revenue Cycle Management (RCM), Credentialing, and Support Services. Our mission is to empower healthcare providers with seamless solutions that enhance operational efficiency and maximize revenue. As we continue to grow, we are looking for dynamic and ambitious professionals to join our Sales team.Position Overview: We are seeking a motivated and experienced Team Lead &ndash; Sales/Business Development for our Pre-Sales department. The ideal candidate will have 2-3 years of relevant experience in Medical Billing or Credentialing Sales, with strong leadership and client acquisition skills. This role involves leading the sales team, managing daily lead assignments, and coordinating closely with the Marketing team for new lead generation while ensuring performance metrics and KPIs are met using official sales portals.Key Responsibilities:<ul><li>Lead and supervise the Pre-Sales/Business Development team to ensure targets and timelines are met.</li><li>Assign daily leads and follow-up tasks to team members.</li><li>Collaborate with the Marketing team to retrieve and work on the latest qualified leads.</li><li>Monitor, track, and report team performance using Salesforce or any other official CRM/sales portal.</li><li>Provide coaching and guidance to the team for handling inbound/outbound inquiries, lead nurturing, and conversion strategies.</li><li>Assist in refining sales scripts and pitch strategies based on client feedback and market trends.</li><li>Ensure accurate documentation of all sales activities and follow-up tasks.</li><li>Contribute to strategic planning and forecasting for sales growth.</li></ul>Skills and Qualifications:<ul><li>Minimum 2-3 years of experience in U.S. Medical Billing or Credentialing Sales/Pre-Sales.</li><li>Prior experience in a supervisory or team lead role is highly preferred.</li><li>Strong understanding of U.S. healthcare systems, billing, and credentialing services.</li><li>Excellent communication, negotiation, and client handling skills.</li><li>Proficient in MS Office, CRM tools (Salesforce, HubSpot), and VoIP platforms (RingCentral, Avaya/Cisco).</li><li>Analytical mindset with the ability to interpret sales data and drive results.</li><li>Detail-oriented, organized, and able to prioritize tasks effectively.</li><li>Bachelor's Degree in Business, Marketing, or a related field; MBA or equivalent is a plus.</li><li>Availability to work U.S. business hours (5:30 PM &ndash; 2:30 AM PST).</li></ul>Perks &amp; Benefits:<ul><li>Paid Leaves</li><li>HR Bonus</li><li>Inflation Bonus</li><li>Promotion Opportunities</li><li>Annual Increments</li><li>Medical Coverage</li><li>Leave Encashment</li><li>Contributory Saving Plan (CSP)</li><li>Saturday and Sunday Off</li><li>Transportation Allowance (for female staff)</li><li>Complimentary Food (Dinner) &amp; Tea/Green Tea (twice daily)</li></ul>Job Details:<ul><li>Industry: Healthcare/Medical Billing</li><li>Department: Pre-Sales/Sales</li><li>Position: Team Lead &ndash; Sales/Business Development</li><li>Total Positions: 1</li><li>Shift: Night Shift</li><li>Job Type: Full Time/Permanent</li><li>Location: Islamabad/Rawalpindi, Pakistan</li><li>Gender: Open to all</li><li>Education: Bachelor&rsquo;s (preferred: BBA, MBA, BSCS, or related fields)</li><li>Experience: 2-3 Years in Sales/Pre-Sales (Medical Billing/Credentialing domain preferred)</li></ul>Why Join Us?<ul><li>Be a part of a fast-growing and forward-thinking healthcare IT organization.</li><li>Collaborative work environment with opportunities for leadership and career advancement.</li><li>Work with an energetic and high-performing team.</li></ul>Job Type: Full-timeWork Location: In person

Team Lead – Sales/Business Development (Pre-Sales Department)

Revmed

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

Spell Engineering

We are a growing organization operating in multiple sectors including engineering services, software solutions, marketing operations, and business development. We are seeking a highly capable professional to oversee our internal teams, streamline operations, and ensure company goals are executed efficiently.Position SummaryThe Operations &amp; Team Management Director will be responsible for supervising the engineering team, marketing teams, HR operations, and overall business workflow. This role acts as the central leadership position responsible for managing daily operations, coordinating between departments, improving team performance, and ensuring company targets are achieved.The position requires strong leadership, organizational management, and strategic planning skills.Key ResponsibilitiesTeam Management<ul><li>Supervise and coordinate the engineering, marketing, and sales teams.</li><li>Ensure effective communication and collaboration between all departments.</li><li>Monitor team performance and productivity.</li><li>Assign tasks, set targets, and track project progress.</li></ul>Engineering Team Oversight<ul><li>Manage the engineering department and ensure project deadlines are met.</li><li>Coordinate with engineers for project planning, resource allocation, and execution.</li><li>Maintain quality standards for technical work and deliverables.</li></ul>Marketing &amp; Business Development<ul><li>Oversee email marketing, cold calling, and lead generation teams.</li><li>Monitor marketing campaigns and sales pipelines.</li><li>Develop strategies to improve lead generation and client acquisition.</li></ul>HR &amp; Recruitment Management<ul><li>Manage hiring processes, interviews, and onboarding of new staff.</li><li>Oversee employee performance evaluations.</li><li>Handle HR policies, staff management, and conflict resolution.</li></ul>Operational Management<ul><li>Develop internal systems to improve workflow efficiency.</li><li>Monitor company KPIs and performance metrics.</li><li>Ensure smooth coordination between departments.</li></ul>Strategic Planning<ul><li>Work closely with company leadership to plan business growth strategies.</li><li>Identify opportunities to improve operations and expand services.</li><li>Help implement new systems, technologies, and automation.</li></ul>Required Skills &amp; Qualifications<ul><li>Strong leadership and management experience</li><li>Excellent communication and team coordination skills</li><li>Experience managing multiple departments simultaneously</li><li>Strong problem-solving and decision-making abilities</li><li>Ability to manage engineering, marketing, and HR functions</li><li>Experience with CRM systems, project management tools, and business reporting</li></ul>Preferred Experience<ul><li>5+ years experience in operations management or executive leadership role</li><li>Experience managing technical teams and marketing teams</li><li>Background in software, engineering, or business operations</li></ul>Key Performance Indicators (KPIs)<ul><li>Team productivity and performance</li><li>Marketing lead generation growth</li><li>Project completion timelines</li><li>Employee retention and performance</li><li>Operational efficiency improvements</li></ul>Position TypeFull-Time | Leadership RoleLocation : Near Asghar Mall Chowk, Main Murree Rd, RawalpindiWork Location: In person

Operations & Team Management Director (Executive Level)

Trend Wave Solutions

Job Title: E-commerce Team LeadCompany: Trend Waves Solutions Location: Onsite - Techno city 2, 6th Road, Rawalpindi Job Type: Full-TimeAbout Trend Waves SolutionsTrend Waves Solutions is a fast-growing e-commerce company specializing in global marketplaces. We operate across the US, UK, and Canada markets, delivering high-quality products and scalable online business solutions.Job OverviewWe are seeking a highly experienced E-commerce Team Lead to manage and scale our operations across major platforms including Amazon, eBay, and Walmart. The ideal candidate will lead a team handling multiple business models and ensure consistent growth, profitability, and operational excellence.Key Responsibilities<ul><li>Lead, manage, and mentor a team working across Amazon, eBay, and Walmart marketplaces</li><li>Oversee operations in US, UK, and Canada markets</li><li>Develop and implement strategies for business growth and scalability</li><li>Manage and optimize multiple models including:</li><li>Arbitrage (Online/Retail)</li><li>Wholesale</li><li>Drop shipping</li><li>Private Label</li><li>Monitor account health, performance metrics, and compliance across all platforms</li><li>Analyze sales data, market trends, and competitor performance</li><li>Coordinate with product sourcing, logistics, and customer support teams</li><li>Ensure smooth order fulfillment, inventory management, and listing optimization</li><li>Troubleshoot account issues, suspensions, or policy violations</li></ul>Requirements<ul><li>3&ndash;5+ years of hands-on experience in e-commerce (Amazon, eBay, Walmart)</li><li>Proven experience managing a team</li><li>Strong knowledge of:</li><li>Arbitrage, Wholesale, Dropshipping, and Private Label models</li><li>Experience working in international markets (US, UK, Canada)</li><li>Familiarity with tools like Helium 10, Jungle Scout, Keepa, etc.</li><li>Strong analytical, leadership, and decision-making skills</li><li>Excellent communication and reporting abilities</li></ul>Preferred Qualifications<ul><li>Experience handling high-volume seller accounts</li><li>Knowledge of marketplace policies and compliance</li><li>Ability to scale new product launches and brands</li></ul>What We Offer<ul><li>Competitive salary package</li><li>Performance-based incentives</li><li>Career growth opportunities</li><li>Professional and collaborative work environment</li></ul>Job Type: Full-timePay: From Rs100,000.00 per monthExperience:<ul><li>E-Commerce: 3 years (Preferred)</li></ul>Work Location: In person

E-commerce Team Lead

Explore 208+ Team lead rcm operations in Rawalpindi this April. Find roles across top companies and apply now to boost your career.