Revenue Cycle Manager

6 hours ago

Manila, National Capital Region, Philippines beBeeDenial Full time ₱6,600,000 - ₱7,800,000

As an Accounts Receivable Specialist, your role will be centered around denial management within Revenue Cycle Management (RCM).

Working on-site in Taguig, Alabang, or Quezon City, you will support physician and hospital billing using UB-04 and/or CMS-1500 forms.

This position requires prior experience in AR calling and denial resolution within a healthcare BPO environment.

Key Responsibilities:
  • Review and analyze denied claims to determine root causes and take corrective actions.
  • Contact insurance companies to resolve outstanding claims and ensure timely reimbursement.
  • Interpret and apply payer-specific guidelines, including capitation agreements.
  • Document all actions taken on claims in the billing system accurately and promptly.
  • Collaborate with internal teams to escalate and resolve complex denial issues.
  • Maintain up-to-date knowledge of billing regulations, payer policies, and industry best practices.
  • Meet productivity and quality targets as defined by the operations team.
Requirements & Skills:
  • SHS graduate or completed at least 2 years of college.
  • Minimum of 3 years of experience as an AR Caller or Senior AR Caller in Revenue Cycle Management (RCM), with a focus on Denial Management.
  • Hands-on experience in Physician Billing, Hospital Billing, or both, using UB-04 and/or CMS-1500 forms.
  • Willing to work on-site in Taguig, Alabang, or in Quezon City.
  • Experience in a BPO Healthcare Account is required.
  • Strong problem-solving abilities, including root cause analysis for claim denials.
  • Familiarity with Capitation Agreements and their impact on billing and reimbursement.
  • Excellent communication and analytical skills to interact with insurance companies and resolve issues efficiently.

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