The RCM Senior Associate plays a key role in ensuring timely and accurate execution of the end-to-end revenue cycle processes, from claim submission to reimbursement. This role supports both routine and strategic RCM functions, helping to maximize revenue collection, maintain compliance, and enhance operational efficiency across multi-state operations.QualificationsRequired:Bachelors degree in Accounting, Finance, Healthcare Administration, or related fieldMinimum of 2 years hands-on experience in US Healthcare Revenue Cycle Management, including claims preparation, billing, denial management, and payer communicationStrong understanding of payer guidelines and revenue cycle processesProficient in Microsoft Office (Excel, Word, Outlook)Strong written and verbal communication skillsProven ability to apply critical thinking and problem-solving in complex billing scenariosPreferred:Experience with Practice Management Systems (e.g., Avatar, Catalyst, PCMS, Therap, Rethink)Familiarity with RCM tools and platforms (e.g., Ability/Inovalon, Netsmart)Prior experience handling multi-state RCM processes or working with diverse insurance carriersStrong analytical, investigative, and reporting skillsRoles & ResponsibilitiesPrepare and submit clean claims to insurance payers and clients via electronic and paper methodsTrack and monitor claim submissions; resolve pre-bill edits and claim rejections in a timely mannerProcess corrected and rebilled claims; manage denials and appeals to ensure timely reimbursementConduct A/R follow-ups and manage collection of outstanding medical accountsCoordinate and execute mass appeal projects with various payersIdentify and resolve discrepancies in billing, payments, or account balancesProcess patient and payer refunds accurately with supporting documentationSupport seamless integration of RCM data into business intelligence platforms (e.g., DOMO)Generate and analyze key RCM performance metrics, month-end summaries, and financial reportsEnsure adherence to payer-specific guidelines and regulatory requirements across multiple statesCollaborate with internal teams and stakeholders to resolve account and data issuesMaintain up-to-date knowledge of reimbursement practices and industry changesDeliver excellent internal and external customer servicePerform additional RCM-related duties as assigned
