(RCM) at least 1 Year RCM healthcrae Exp in BPO 30k to 36k

4 weeks ago

Manila, Philippines GGAS Services Full time

Revenue Cycle Management (RCM) Specialist
We are seeking a skilled and detail-oriented RCM Specialist to join our team. The ideal candidate will bring expertise in healthcare billing, claims management, and accounts receivable, ensuring seamless revenue operations and exceptional provider support.
Key Responsibilities
Perform accounts receivable follow-up, denial management, and claim status verification.
Handle UB04 forms, facility claims, and professional claims (CMS 15,000).
Review contracts to resolve payment disputes (TPO disputes).
Collaborate with insurance payers for claim statuses and payment resolutions.
Coordinate benefits and provide detailed explanations of benefits (EOBs).
Ensure timely follow-up on undisputed claims and process payments accurately.
Oversee prior authorization and utilization review processes.
Qualifications
Proven experience working on the provider side (hospital-based).
Knowledge of HIPAA regulations, CPT codes, and ICD codes.
Strong understanding of medical billing processes and claims adjudication.

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