Reconciliation Specialist - US Healthcare

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.

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