Revenue Cycle Management

3 weeks ago

Taguig, National Capital Region, Philippines HR TechX Corp. Full time
Overview

The Revenue Cycle Management (RCM) Senior Associate role supports end-to-end revenue cycle processes, from claim submission to reimbursement. This position helps maximize revenue collection, maintain compliance, and enhance operational efficiency across multi-state operations.

Responsibilities
  • Prepare and submit clean claims to insurance payers and clients via electronic and paper methods
  • Track and monitor claim submissions; resolve pre-bill edits and claim rejections in a timely manner
  • Process corrected and rebilled claims; manage denials and appeals to ensure timely reimbursement
  • Conduct A/R follow-ups and manage the collection of outstanding medical accounts
  • Coordinate and execute mass appeal projects with various payers
  • Identify and resolve discrepancies in billing, payments, or account balances
  • Process patient and payer refunds accurately with supporting documentation
  • Support seamless integration of RCM data into business intelligence platforms (e.g., DOMO)
  • Generate and analyze key RCM performance metrics, month-end summaries, and financial reports
  • Ensure adherence to payer-specific guidelines and regulatory requirements across multiple states
  • Collaborate with internal teams and stakeholders to resolve account and data issues
  • Maintain up-to-date knowledge of reimbursement practices and industry changes
  • Deliver excellent internal and external customer service
  • Perform additional RCM-related duties as assigned
Qualifications
  • Bachelors degree in Accounting, Finance, Healthcare Administration, or related field
  • Minimum of 2 years hands-on experience in US Healthcare Revenue Cycle Management, including claims preparation, billing, denial management, and payer communication
  • Strong understanding of payer guidelines and revenue cycle processes
  • Proficient in Microsoft Office (Excel, Word, Outlook)
  • Strong written and verbal communication skills
  • Proven ability to apply critical thinking and problem-solving in complex billing scenarios
Preferred
  • Experience with Practice Management Systems (e.g., Avatar, Catalyst, PCMS, Therap, Rethink)
  • Familiarity with RCM tools and platforms (e.g., Ability/Inovalon, Netsmart)
  • Prior experience handling multi-state RCM processes or working with diverse insurance carriers
  • Strong analytical, investigative, and reporting skills
Job Details
  • Employment type: Full-time
  • Job function: Accounting/Auditing and Finance
  • Industries: Technology, Information and Internet

Note: This refinement removes unrelated postings and extraneous content while preserving the core role information.


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