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RCM Account Specialist
2 hours ago
We're Hiring: RCM Account Specialist (Healthcare)
The Account Specialist plays a critical role in supporting a designated caseload of home care providers to ensure timely, accurate decisions regarding third-party billing. In this role, you will act as a trusted partner to customers through troubleshooting issues, resolving billing concerns, and proactively monitoring account health to prevent disruptions. You will leverage analytical tools, collaborate across teams, and maintain clear communication to drive positive outcomes and an exceptional customer experience. This position reports to the Manager of Account Management.
Location: Pasig, Philippines
Work Mode: Work From Office
Role: RCM Account Specialist (Healthcare)
What You'll Do:
- Process claims in accordance with payer regulations, medical authorizations, protocols, and departmental guidelines
- Investigate and resolve claim denials and rejections using payer resources, clearinghouse tools, and internal documentation
- Identify, research, and analyze trends in submitted claims to develop actionable resolutions
- Provide timely and professional support via email using a ticketing system to resolve customer inquiries
- Assist customers with setup and navigation of billing platforms, software tools, or other program features as needed
- Maintain consistent and proactive communication to ensure customers feel informed and supported
- Monitor overall account health, including authorization expirations, clearinghouse rejections, aging reports, and payer trends
- Utilize Power BI and other reporting tools to analyze data, uncover discrepancies, and build action plans for issue resolution
- Document all updates and interactions thoroughly within the CRM to ensure continuity and reduce repeat inquiries
What We're Looking For:
- Minimum 2 years of experience in revenue cycle management (RCM), healthcare billing, or related functions with emphasis on third-party payer claims
- Proficiency with CRM systems (HubSpot preferred) and billing software
- Strong written and verbal communication skills with professional business etiquette
- Excellent time management, organization, and follow-up skills
- Demonstrated problem-solving and decision-making abilities
- Experience with project management or leading process improvements
- Familiarity with analytical tools such as Power BI or similar reporting platforms
- Proficiency with Microsoft Office Suite (Outlook, Word, Excel)
Job Types: Full-time, Permanent
Pay: Php35, Php40,000.00 per month
Benefits:
- Additional leave
- Company Christmas gift
- Company events
- Health insurance
- Opportunities for promotion
- Paid training
- Promotion to permanent employee
Application Question(s):
- Can you share your healthcare billing process from the initial to final step?
- Do you have experience working for revenue cycle management under healthcare?
- Do you have experience with tools like EPIC, Availity and any clearing houses?
- Do you have experience using any CRM platforms like Salesforce, HubSpot, or any similar tools?
- Have you resolved any claim denials and discrepancies?
- Have you worked with any third-party payors like Medicaid, Veterans Affair, etc.?
Work Location: In person
