Opportunity Description
Overview
We are seeking a Revenue Cycle Management (RCM) Domain Expert with in-depth knowledge of local healthcare regulations, payer requirements, and medical claims workflows. This role will be responsible for ensuring the system’s medical rules, claims logic, and insurance workflows are accurate, up-to-date, and aligned with market needs.
Key Responsibilities- Act as the subject matter expert for RCM processes, claims lifecycle, and payer-specific rules.
- Maintain and validate medical and insurance rules inside the platform to ensure compliance.
- Monitor market changes, including regulator updates, payer table of benefits, and coding standards.
- Collaborate with engineering and AI teams to ensure accurate automation of claims workflows.
- Define acceptance criteria for RCM-related features and validate implementation.
- Support user acceptance testing (UAT) for RCM and insurance modules.
- Train inter...