Senior Specialist
On-siteChennai, Tamil Nadu, India
Job Summary
Oversee and validate charge posting, payment posting, AR follow-up, denial management, and reporting to ensure accuracy and compliance. Conduct root cause analysis of recurring denials and implement corrective actions while handling complex client and operational escalations. Perform quality reviews, reconciliations, and audits against payer regulations and organizational policies. Act as a Subject Matter Expert for Cardiology revenue cycle processes, mentoring team members on workflows and best practices. Collaborate with leadership on process improvements and support new client implementations. Ensure adherence to HIPAA, ISMS, and QMS standards. This role supports the revenue cycle team in delivering high-quality service and driving operational excellence.
Required Qualifications
- Senior Specialist in IMS, eCW, Athena and Carecloud
- expertise in charge posting
- expertise in payment posting
- expertise in AR management
- expertise in patient statements
- expertise in reporting
- ability to act as a subject matter expert (SME) for the team
- ability to provide advanced support in resolving complex issues
- ability to mentor junior specialists
- ability to ensure process excellence
- ability to ensure client satisfaction
- ability to oversee and validate charge posting
- ability to oversee and validate payment posting
- ability to oversee AR follow-up
- ability to oversee denial management
- ability to oversee reporting activities
- ability to handle complex client escalations
- ability to handle complex payer escalations
- ability to handle complex operational escalations
- ability to provide timely resolution
- ability to provide recommendations for issue prevention
- ability to conduct root cause analysis of recurring denials
- ability to conduct root cause analysis of rejections
- ability to conduct root cause analysis of underpayments
- ability to conduct root cause analysis of process discrepancies
- ability to implement corrective actions
- ability to improve outcomes
- ability to monitor operational performance metrics
- ability to monitor revenue cycle performance metrics
- ability to ensure adherence to quality standards
- ability to ensure adherence to productivity standards
- ability to ensure adherence to service delivery standards
- ability to perform quality reviews
- ability to perform reconciliations
- ability to perform audits
- ability to ensure compliance with payer regulations
- ability to ensure compliance with client requirements
- ability to ensure compliance with organizational policies
- ability to act as a Subject Matter Expert (SME) for Cardiology revenue cycle processes
- ability to support team members with process-related guidance
- ability to support team members with issue resolution
- ability to mentor and train Specialists on process workflows
- ability to mentor and train Specialists on PMS applications
- ability to mentor and train Specialists on payer guidelines
- ability to mentor and train Specialists on best practices
- ability to improve overall team performance
- ability to support onboarding initiatives
- ability to support cross-training initiatives
- ability to enhance workforce flexibility
- ability to enhance knowledge retention
- ability to collaborate with Team Leaders
- ability to collaborate with Managers
- ability to identify process improvement opportunities
- ability to identify workflow enhancements
- ability to identify automation initiatives
- ability to assist in the preparation of operational reports
- ability to assist in the preparation of performance dashboards
- ability to assist in the preparation of audit findings
- ability to assist in the preparation of client-facing insights
- ability to support process transitions
- ability to support new client implementations
- ability to support special projects
- ability to ensure compliance with HIPAA
- ability to ensure compliance with ISMS
- ability to ensure compliance with QMS
- ability to ensure compliance with payer regulations
- ability to ensure compliance with client-specific requirements
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