Job Description

Please Note:

English

language proficiency is

required

for this role. This is a

full-time

,

work from office

role. This requires a U.S. schedule - India

Night shift.*

Work Location:

This is a

Work from Office

position and location is

Bangalore

at:
Block 12B, Pritech Park,3rd Floor,

SEZ Survey No 51-64/4,

Bellandur,Village. Bldg 9A Rd,

Bengaluru -Karnataka 560103

Shift: Night

Contact:

Nirmala 911 301 5045

Pay:

4-9 LPA

Build Your Future! Come join our thriving team as a Claims Resolution Specialist! We are seeking ambitious, self-motivated and driven people just like you for a rewarding career in the RCM Healthcare arena.

Why should you consider TSI (part of TSI family of companies)?

Paid training Team-oriented work environment Growth opportunity Generous Incentive opportunity Comprehensive benefits package available: including medical insurance, paid time off and paid holidays! Transport facility (As per policy and shift) - Transportation provided Working 5 days/week

TSI Healthcare specializes in revenue cycle management, offering tailored solutions for healthcare providers to address third-party insurance claims denials, manage underpayments, and optimize reimbursement processes. The Claim Resolution Specialist plays a versatile role in the claims workflow, tasked with submitting appeals to overturn denials and trigger payments or determining whether further action, such as additional appeals or account closure, is required. Specialists in this role may prioritize tasks based on claim complexity and workload, ensuring optimal productivity while maintaining compliance and accuracy. By efficiently processing high volumes of low-balance claims, the specialist ensures compliance, accuracy, and revenue recovery that supports client success.

Effectively communicate expectations, consequences, changes, policies, and procedures. Supervise, mentor, and evaluate the performance of revenue cycle staff, including billers, coders, and collectors. Provide ongoing feedback to employees regarding quality, performance, and improvement opportunities. Conduct regular team meetings, provide training, and foster a positive work environment that encourages professional development and team collaboration. Present, promote, and support all new initiatives. Accurately project and achieve daily, weekly, and monthly revenue goals. Accountable for all decisions, actions and directives with respect to job responsibilities. When requested, manage and track accounts closed by Client within established guidelines. When requested, conduct monthly audits to ensure that accounts have been executed in compliance with Client's requirements. Oversee the daily operations of the revenue cycle, including billing, coding, claim submission, payment posting, and collections. Ensure all claims are processed efficiently and in compliance with payer requirements, and that denials are addressed promptly. Maintain up-to-date knowledge of healthcare regulations, payer requirements, industry best practices, compliance, and enforcement of all applicable Federal, State, and Local laws and regulations relating to job duties, including HIPAA. Knowledge, understanding, and compliance with TSI policies and procedures. Participation in Company Programs; must meet minimum performance standards. Responsible for respective department's overall performance and for motivating team to exceed department goals and objectives. Responsible for progressive discipline with regards to attendance, performance and all aspects of company policy up to and including termination. Provide insights and recommendations to senior management to drive decision-making and improve financial outcomes. Follow up in a timely manner to ensure customer satisfaction. Prepare and analyze regular financial reports to monitor the performance of the revenue cycle, including metrics such as days in accounts receivable (AR), denial rates, and collection rates. Perform other duties as assigned by management.


Bachelor's degree in Healthcare Administration, Business Administration, or a related field preferred. 3 years of previous healthcare revenue cycle management, with at least 1-2 years in a supervisory or leadership role. Working knowledge of Microsoft Excel and Word. Strong knowledge of medical billing and coding, healthcare regulations, and payer requirements. Excellent leadership, communication, and problem-solving skills. Proficiency in healthcare billing software and electronic health records (EHR) systems. Strong work ethic that exhibits high ethical and moral standards Certified Revenue Cycle Representative (CRCR), Certified Professional Coder (CPC), or similar certification preferred. Ability to supervise and effectively train staff members Must be able to communicate effectively, manage time effectively to ensure production standards are always maintained


This job description is not an exclusive or exhaustive list of all job functions that a team member in this position may be asked to perform. Duties and responsibilities can be changed, expanded, reduced, or delegated by management to meet the business needs of the company.

We provide Equal Employment Opportunity for all individuals regardless of race, color, religion, gender, age, national origin, marital status, sexual orientation, status as a protected veteran, genetic information, status as a qualified individual with a disability and any other basis protected by federal, state or local laws

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