Job Description
This role is for one of the Weekday's clients
Min Experience: 2 years
Location: Bangalore, Mumbai
JobType: full-time
We are seeking a detail-oriented and analytical Reconciliation (Recon) Specialist with a strong foundation in US Healthcare processes. The ideal candidate will have a medical educational background and hands-on experience in healthcare reconciliation, medical coding, or medical transcription. This role requires a deep understanding of healthcare data, billing workflows, and accuracy in financial and clinical record alignment to ensure compliance and operational efficiency.
Requirements
Key Responsibilities:
- Perform end-to-end reconciliation of healthcare records, including patient data, billing information, claims, and payments.
- Validate and cross-check data between multiple systems such as EHR/EMR, billing platforms, and payer systems.
- Identify discrepancies in claims, payments, coding, or patient records and take corrective actions.
- Work closely with medical coding, billing, and AR teams to resolve inconsistencies.
- Analyze denial patterns and reconciliation gaps to improve process efficiency.
- Ensure compliance with US healthcare regulations, including HIPAA guidelines.
- Maintain accurate documentation and audit trails for all reconciliation activities.
- Support month-end and quarter-end financial reconciliation processes.
- Collaborate with internal stakeholders to streamline workflows and reduce errors.
Required Qualifications:
- Educational background in Life Sciences, Medicine, Nursing, Pharmacy, or any related medical field (mandatory).
- 2–5 years of experience in US Healthcare, specifically in reconciliation, medical coding, billing, or transcription.
- Strong understanding of US healthcare systems, insurance workflows, and revenue cycle management (RCM).
- Proficiency in Medical Coding (ICD-10, CPT, HCPCS) is required.
- Experience working with EHR/EMR systems and healthcare billing tools.
- Good knowledge of claims adjudication and payment posting processes.
- Strong analytical and problem-solving skills with high attention to detail.
Preferred Qualifications:
- 2–3 years of experience in Medical Coding or Medical Transcription.
- Familiarity with denial management and AR follow-ups.
- Certifications such as CPC (Certified Professional Coder) or equivalent are a plus.
Key Skills:
- US Healthcare Processes
- Medical Coding & Documentation
- Healthcare Reconciliation
- Revenue Cycle Management (RCM)
- Data Analysis & Validation
- Attention to Detail
- Compliance & Regulatory Knowledge
Soft Skills:
- Strong communication and collaboration abilities
- Ability to work under tight deadlines and manage multiple priorities
- High level of accuracy and accountability
- Problem-solving mindset with a proactive approach