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Healthcare Revenue Cycle Director

1 week ago

Manila, National Capital Region, Philippines Pointwest Innovations Corp. Full time
Revenue Cycle Management

We are seeking a highly skilled Healthcare Revenue Cycle Director to join our team at Pointwest Innovations Corp. As a key member of our revenue cycle management team, you will play a crucial role in overseeing and managing the entire ER billing cycle.

The ideal candidate will have excellent analytical and problem-solving skills for claim resolution, as well as strong leadership and mentoring abilities to train and support billing staff.

  • Oversee and manage the entire ER billing cycle, ensuring accuracy and compliance with industry regulations.
  • Prepare and submit billing data and medical claims to insurance companies, Medicare, Medicaid, and third-party payers.
  • Verify and ensure the accuracy of patient information, procedure codes and diagnosis codes in accordance with payer policies and compliance guidelines.
  • Analyze and resolve complex billing issues, including high-valued claims, appeals, and insurance disputes.
Responsibilities

Your responsibilities will include:

  • Managing the entire ER billing cycle, ensuring accuracy and compliance with industry regulations.
  • Preparing and submitting billing data and medical claims to insurance companies, Medicare, Medicaid, and third-party payers.
  • Verifying and ensuring the accuracy of patient information, procedure codes and diagnosis codes in accordance with payer policies and compliance guidelines.
  • Analyzing and resolving complex billing issues, including high-valued claims, appeals, and insurance disputes.
Requirements

To be successful in this role, you will need:

  • A university/college degree.
  • Excellent written and spoken communication skills.
  • Strong analytical and problem-solving skills for claim resolution.
  • Leadership and mentoring abilities to train and support billing staff.
  • Detail-oriented with a strong focus on accuracy and compliance.
  • Ability to work in a fast-paced ER environment with high patient volumes.
  • At least 1 to 2 years experience in Medical Billing, preferably in an emergency room or urgent care setting.
  • Experience in popular EMRs and medical coding/billing platforms is an asset.
  • Strong understanding of CPT, ICD-10, HCPCS coding, and insurance guidelines.
  • Certified Professional Biller (CPB) or Certified Professional Coder (CPC) is a plus.