Revenue Cycle Management (RCM) Senior Associate | US-based Healthcare

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.

Qualifications

Required :

Bachelors degree in Accounting, Finance, Healthcare Administration, or related field

Minimum of 2 years hands-on experience in US Healthcare Revenue Cycle Management , including claims preparation, billing, denial management, and payer communication

Strong understanding of payer guidelines and revenue cycle processes

Proficient in Microsoft Office (Excel, Word, Outlook)

Strong written and verbal communication skills

Proven ability to apply critical thinking and problem-solving in complex billing scenarios

Preferred :

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 carriers

Strong analytical, investigative, and reporting skills

Roles & Responsibilities

Prepare and submit clean claims to insurance payers and clients via electronic and paper methods

Track and monitor claim submissions; resolve pre-bill edits and claim rejections in a timely manner

Process corrected and rebilled claims; manage denials and appeals to ensure timely reimbursement

Conduct A / R follow-ups and manage collection of outstanding medical accounts

Coordinate and execute mass appeal projects with various payers

Identify and resolve discrepancies in billing, payments, or account balances

Process patient and payer refunds accurately with supporting documentation

Support seamless integration of RCM data into business intelligence platforms (e.g., DOMO)

Generate and analyze key RCM performance metrics, month-end summaries, and financial reports

Ensure adherence to payer-specific guidelines and regulatory requirements across multiple states

Collaborate with internal teams and stakeholders to resolve account and data issues

Maintain up-to-date knowledge of reimbursement practices and industry changes

Deliver excellent internal and external customer service

Perform additional RCM-related duties as assigned