Clinical Application Specialist – Billing & RCM

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Job Description

Is Responsible for end-to-end implementation of Billing module. He/she must be a graduate with a minimum experience of 5 years in Healthcare RCM, Insurance, and claims workflow with Hospital/Payer/Provider billing process.

Experience with billing coding, DRG, is a must.

Experience working with at least two ERP implementation projects and should be aware of Implementation methodologies.

Application skills:

  • HL7 and EDI
  • DRG
  • TOB
  • Agreements and Contracts
  • Hospital billing / workflows
  • Integration experience with ERP and EMR, ERP to TPA Portals, ERP to Payment Gateway/SMS gateway
  • Well versed with Standards for Managed Care/HIMSS/EMRAM/Patient identification/Data privacy and safety & Medical Records.

Skills

  • Administrative skills:
  • Ability to build relationships in a consultative and collaborative manner.
  • Excellent communication skills with demonstrated deliveries adhere to timelines.
  • Excellent MS Office skills, workflow diagrams, Document preparation and Presentation skills.
  • Excellent verbal and written communication skills.
  • Highly skilled in – Corporate presentations, Requirements gathering, Functional testing and troubleshooting, Validation scripts preparation and execution, Functional and business documentation, post go live support and End user support and training during project life cycle.