Revenue Cycle Management Specialist - Care Navigation (Medicare CHI/PIN)

2070 Health, part of W Health Ventures, has established India's first healthcare-focused Venture Studio that incubates innovative healthcare companies. The studio is involved in idea generation, operations, and strategic decisions for new healthcare ventures, including companies in the US care navigation space.

Location: India (remote, US shift hours)

Responsibilities

• Own end-to-end Revenue Cycle Management (RCM) for Medicare Community Health Integration (CHI) and Principal Illness Navigation (PIN) claims, from eligibility verification through payment posting and reconciliation.
• Audit charge capture against time logs and clinical documentation to ensure clean CHI / PIN submissions.
• Work clearinghouse edits, manage denials, and run appeals to closure.
• Run AR aging, payment posting, and ERA / EOB reconciliation; flag payer and MAC-specific trends to leadership.
• Partner with care navigators and clinicians to close documentation gaps, and report KPIs back to the team.

Requirements

• 2 to 5 years of hands-on US medical billing / revenue cycle experience, ideally at an Indian healthcare BPO or US-RCM offshore captive (Omega Healthcare, AGS Health, GeBBS Healthcare, R1 RCM, Access Healthcare, NTT DATA / Net-Healthcare, Sutherland Healthcare, EXL Health, Cognizant Healthcare, Wipro, Infosys BPM, or similar).
• Direct, demonstrable experience billing Medicare Part B claims.
• Hands-on experience with the full CHI and PIN code family: CHI (G0019, G0022), PIN (G0023, G0024), and PIN-Peer Support Services (G0140, G0146). Exposure to adjacent and other time-based Medicare G-codes is important.
• Strong working knowledge of related care-coordination codes: CCM (99490, 99439, 99487, 99489), PCM (99424 to 99427), TCM (99495, 99496), BHI (99484, 99492 to 99494), and RPM (99453 to 99458).
• Fluent in HCPCS, CPT, and ICD-10-CM coding for chronic and serious-illness populations.
• Comfortable with EHR / PMS (Athenahealth, eClinicalWorks, AdvancedMD, DrChrono, Epic, Cerner, Kareo, or similar) and a US clearinghouse (Availity, Change Healthcare / Optum, Trizetto, Waystar).
• Excellent written and verbal English communication; comfortable on calls with US-based providers and care teams.
• Based in India; comfortable working US night shift hours (EST or CST overlap) and a stable home internet setup for fully remote work.

Benefits

• Competitive India-market base salary, group medical insurance for self and family, PF, gratuity, fully remote work-from-home setup, flexible PTO, and an annual learning & certification stipend (AAPC, AHIMA).