Required Skills s Domain Expertise
Strong understanding of U.S. Healthcare RCM including charge entry,
payment posting, denial analysis, and AR follow-up.
In-depth knowledge of payer rules (Medicare, Medicaid, commercial
payers).
Working knowledge of CPT, ICD-10, HCPCS, modifiers, and ERA/EDI 835-
837 transactions.
Demonstrated ability to identify root causes behind denials and system-level
billing issues.
Technical Competencies
Hands-on experience with one or more medical billing systems:
CollaborateMD, Kareo, AdvancedMD, Athenahealth, eClinicalWorks,
DrChrono, NextGen, PracticeSuite, or similar.
Experience using clearinghouse portals such as Waystar, Availity, and
Change Healthcare.
Familiarity with ticketing tools like Zendesk, Freshdesk, or Salesforce
Service Cloud.
Strong Excel skills for reporting, validation, and analysis (pivot tables,
lookups).
Customer Support Competencies
Analytical thinker who investigates workflow issues instead of surface-level
resolutions.
Excellent written and verbal communication skills tailored for non-technical
audiences.
Ability to collaborate with internal product or development teams for
technical fixes and process improvements.
Proven record of maintaining high CSAT scores and quick response times.
Qualifications
Bachelor’s Degree (preferably in Commerce, Healthcare Administration, or
related field).
3–6 years of relevant experience in U.S. Healthcare RCM.
Certifications preferred: HIPAA Awareness, AAPC CPC (in progress or
completed).