Revenue Cycle Management Professional

5 days ago


Manila, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time

Job Description

  • Responsibilities: Develop curriculum, training syllabus, and course modules related to Medical Billing (US Health Insurance, Claims Process, Denials & Appeals, Revenue Cycle Management)
  • Develop Basic Account Navigation Workflow of Billing System for both HP and PB (Epic, Athena) and other system tools (Encoder Pro, CCI Edit) used by the department.
  • Develops Denials Process workflow for Common Denials (Duplicate, Timely Filing, No Prior-Auth, Medical Necessity, etc.)
  • Develops a guideline for common Payer Policies for the Top US Health Insurance Payers (Aetna, BCBS, Humana, UHC, Cigna, etc.)
  • Update and improve existing training and process modules.
  • Coordinate with forensic quality department to identify areas for process improvement and produce materials for claim edits, denials workflow, systems & process training from client.
  • Develops and produces materials for Medical Billing, Denials, Systems and Process exercises and qualifying examinations.
  • Updates weekly deck (performance and attendance for training meeting).
  • Participates in weekly training meetings with the upper management.
  • Collaborates with billing operations managers, supervisors, and quality to resolve issues that impact internal and external customers.
  • Develops and conducts Call/Phone Handling Training for the new hires and existing forensic billers.


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