Revenue Cycle Management

21 hours ago

Manila, National Capital Region, Philippines HRTX Full time $60,000 - $80,000 per year

The RCM Senior Associate plays a key role in ensuring timely and accurate execution of the end-to-end revenue cycle processes, from claim submission to reimbursement. This role supports both routine and strategic RCM functions, helping to maximize revenue collection, maintain compliance, and enhance operational efficiency across multi-state operations.

Qualifications

Required:

  • 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

Roles & 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 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

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