Healthcare RCM Professional

Job highlights

• Demonstrated expertise in ICD 10 CM,CPT,and HCPCS Level II coding,including complex modifiers and payer-specific requirements. Strong hands-on experience in Clinical Documentation Excellence (CDE),physician queries,and improving provider documentation quality.

  Job Title             Health Care Consultant RCM             Exp             5+yrs             Location             Any             JD             5 6 years of experience in medical coding, claims adjudication, charge capture, and healthcare billing within provider, hospital, ASC, or DME environments.
  

Demonstrated expertise in ICD 10 CM, CPT, and HCPCS Level II coding, including complex modifiers and payer-specific requirements.
Strong hands-on experience in Clinical Documentation Excellence (CDE), physician queries, and improving provider documentation quality.
Proven experience in medical device credit coding and billing, including DME equipment, implants, returns, warranty credits, and payer-driven credit adjustments.
Experience supporting charge capture integrity, reconciliation, and revenue leakage analysis.
Background handling claim rejections, denials, appeals, and root cause analysis to drive first-pass resolution and reduce A/R.
Exposure to payer rules, NCCI edits, medical necessity guidelines, LCD/NCD compliance, prior authorization requirements, and reimbursement models.
Experience working with cross-functional teams including providers, clinical operations, revenue integrity, and payer relations to resolve complex billing issues.
Familiarity with EHR/PM systems such as Epic, Cerner, Athena, NextGen, Meditech, eClinicalWorks, or equivalent.

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