Rcm Specialist

Description:

CareGenix Solutions is looking for an experienced RCM Specialist with a specialization in Wound Care to join their growing team at their Karachi office located in Cherry’s Plaza, DHA Phase 7. This is an on-site night shift role from 6:00 PM to 3:00 AM, offering a market-competitive salary along with a fuel allowance and room for discussion on compensation during screening.

The ideal candidate will bring 3–5 years of hands-on experience in Revenue Cycle Management (RCM), specifically within the Wound Care domain, and a results-driven approach to healthcare financial processes. This role requires a strong understanding of the complete RCM process, from patient registration and charge entry to claims submission, payment posting, and denial management.

Key Responsibilities:

• Manage and oversee the end-to-end RCM cycle, ensuring efficient billing and collections.

• Process medical claims related to wound care services in compliance with payer requirements.

• Work closely with healthcare providers and insurance companies to resolve claim issues and ensure timely reimbursements.

• Conduct audits and maintain accurate documentation for billing activities.

• Address and manage denials, rejections, and appeals effectively.

• Use RCM software systems to process, track, and follow up on claims.

• Collaborate with internal teams for process optimization and performance improvements.

The ideal candidate should have:

• Proven experience in Wound Care billing within the US healthcare system.

• In-depth knowledge of insurance guidelines, CPT/ICD codes, and compliance protocols.

• Excellent analytical and communication skills.

• Ability to work independently and under pressure in a night shift environment.