Job Description

About Us:

Yogesher is a healthcare revenue cycle management and medical billing company offering global capabilities & specialized solutions. By utilizing industry-leading technology in conjunction with high-touch relationship building, we enable healthcare practitioners and facilities to focus on patient care, maintain financial independence, and cultivate financial success--an end-to-end value-added services partner for extended.

Position Overview:

We are looking for a Revenue Cycle Management Expert to lead and optimize the billing processes within our dynamic healthcare organization. This role is essential for driving operational excellence, ensuring timely and accurate revenue capture, and maximizing reimbursement. As the primary subject matter expert, you will play a critical role in ensuring that our billing office operates smoothly, efficiently, and in full compliance with all regulations.

The ideal candidate is a seasoned professional with a deep understanding of the end-to-end revenue cycle, from coding and claims submission to payment reconciliation and denial management. You should have a strong track record in improving revenue cycle performance, minimizing accounts receivable days, and enhancing the overall financial health of the organization.

Key Responsibilities:

End-to-End Revenue Cycle Management

:- Oversee and manage all stages of the revenue cycle, from charge entry and coding accuracy to claims submission, payment posting, and collections. Ensure all processes are aligned to reduce errors, improve cash flow, and expedite claim resolutions.

Claims Processing & Denial Resolution

:- Manage the submission of clean claims, including timely follow-up on rejected or denied claims. Utilize expertise to successfully appeal denied claims, ensuring that payments are maximized and outstanding balances are collected efficiently.

Coding & Billing Compliance

:- Work closely with coders to ensure accurate coding for CPT, ICD-10, and HCPCS. Stay updated on coding changes, payer policies, and compliance standards to ensure that all claims are accurate and compliant with regulatory guidelines.

Insurance Verification & Authorization

:- Partner with front-office and clinical teams to verify insurance eligibility, obtain necessary authorizations, and ensure that all pre-claim requirements are met before claims are submitted to reduce the chance of denial.

Financial Reporting & Revenue Optimization

:- Generate and analyze financial reports, focusing on key performance metrics like days in accounts receivable (AR), denial rates, and cash collection cycles. Use data to drive strategies for improving overall revenue cycle performance and reducing outstanding AR.

Patient Billing & Account Management

:- Provide guidance and support for patients with billing inquiries, addressing concerns, and facilitating payment plan arrangements. Maintain a high level of patient satisfaction by providing clear, accurate, and timely information regarding their accounts.

Process Improvement & Efficiency

:- Continuously evaluate and refine revenue cycle processes to identify inefficiencies or bottlenecks. Lead initiatives to implement process improvements and enhance team performance, such as reducing AR days, improving claim accuracy, and increasing the first-pass resolution rate.

Compliance & Risk Management

:- Ensure the billing office remains compliant with HIPAA, CMS guidelines, insurance requirements, and state/federal regulations. Conduct regular audits and participate in internal and external reviews to ensure full regulatory compliance.

Credentialing & Enrollment

:- Oversee and manage the credentialing and enrollment processes for healthcare providers with payers. Ensure that all necessary documentation, contracts, and renewals are submitted on time to prevent disruptions in provider reimbursement. Maintain up-to- date knowledge of payer requirements for credentialing and revalidation.

Requirements:

Experience:

5+ years of hands-on experience in revenue cycle management with a focus on medical billing, coding, and collections. At least 3 years of experience in a leadership or expert-level role within a healthcare organization.

Skills & Expertise:

Extensive knowledge of medical billing systems and coding (ICD-10, CPT, HCPCS). Proficiency with electronic health record (EHR) systems and practice management software (e.g., Epic, Cerner, NextGen). Expertise in insurance verification, payer contracts, and prior authorization processes. Strong understanding of payer reimbursement models, including government (Medicare, Medicaid) and commercial insurance. In-depth experience in denial management, appeals, and collection strategies. Proficient in financial reporting, key performance metrics, and AR management. Excellent communication and interpersonal skills, capable of interacting with patients, insurance companies, and internal teams. Strong leadership, problem-solving, and conflict-resolution skills.

Key Competencies:

Strategic Thinking

: Ability to assess the big picture, identify trends, and develop actionable strategies to optimize the revenue cycle.

Attention to Detail

: Exceptional focus on accuracy, ensuring no missed opportunities for payment and minimizing errors in billing,

Problem Solving

: Strong ability to analyze complex billing issues, develop solutions, and drive results through careful planning and execution.

Leadership

: A natural mentor and team leader, capable of motivating and guiding staff while fostering a collaborative and high-performance work environment.

Customer Focus

: Commitment to providing outstanding service to both internal stakeholders and patients by addressing concerns and improving overall satisfaction.

Adaptability

: Comfortable navigating change in a fast-paced, ever-evolving healthcare landscape.
Job Types: Full-time, Permanent

Pay: ?40,000.00 - ?60,000.00 per month

Benefits:

Health insurance Leave encashment Paid sick time Provident Fund
Schedule:

Day shift Morning shift
Work Location: In person

Application Deadline: 29/05/2025