The RCM Expert is responsible for handling complex Revenue Cycle Management (RCM) activities, resolving claims, denials, payment, and account-related issues, and ensuring accurate and timely completion of assigned workflows. The role also supports junior team members with process guidance and contributes to quality improvement, denial reduction, AR movement, and overall process efficiency.

Key Responsibilities:

• Handle complex RCM tasks, claims, denials, corrections, payment issues, and account follow-ups.
• Review and resolve process issues using payer guidelines, client instructions, SOPs, and system information.
• Support denial management, appeals, claim corrections, and identification of preventable denial trends.
• Follow up on aging accounts, pending items, payer responses, and unresolved inventory to support AR movement.
• Provide basic process guidance and clarification to junior team members.
• Identify errors, recurring issues, and process gaps and support corrective actions.
• Maintain accurate documentation, account notes, trackers, and follow-up records.
• Meet assigned productivity, quality, turnaround time, and process compliance requirements.
• Escalate complex or unresolved issues to the appropriate Team Lead or senior resource.