RCM Supervisor

Position Title: Claims Resolution Specialist

Location: Iloilo City, Philippines

Employment Type: Full-Time (On-site)

Overview

We are hiring experienced professionals to join our healthcare claims processing team as Assistant Managers. In this role, you will support the Call Center Operations Manager and help lead a team of approximately 25 Claim Resolution Specialists. You'll focus on performance monitoring, coaching, and process improvement to ensure operational success.

Ideal candidates are organized, proactive, and have a solid background in call center operations,preferably with exposure to healthcare back-office functions such as Revenue Cycle Management (RCM) or Accounts Receivable (AR).

Key Responsibilities

● Support the Operations Manager in supervising and managing day-to-day activities of the call center team.

● Provide direct coaching and mentoring to a team of Claim Resolution Specialists to drive

efficiency and quality.

● Monitor key performance metrics and assist in implementing strategies for improvement.

● Promote a culture of continuous improvement and accountability within the team.

● Assist with workforce planning and ensure shift schedules are met.

● Support quality assurance efforts and maintain high levels of customer service.

● Participate in performance evaluations and provide regular feedback to team members.

● Communicate updates and process changes clearly to ensure team alignment.

● Collaborate with internal departments such as Quality, Training, IT, and HR to address operational needs.

● Assist in the recruitment, onboarding, and training of new team members.

● Act as a liaison between the frontline team and management to escalate concerns and share insights.

● Serve as a subject matter resource on claims resolution processes and client expectations.

● Take on additional responsibilities as required by leadership.

Candidate Profile

Required Qualifications:

● 5-7 years of experience in call center operations, ideally in healthcare (RCM/AR preferred).

● Minimum of 2 years of experience in a leadership or supervisory role.

● Bachelor's degree or equivalent work experience.

● Fluent in English with strong verbal and written communication skills.

● Proficient in Microsoft Office tools (Excel, Word, Outlook, PowerPoint).

● Strong problem-solving, coaching, and interpersonal skills.

● Ability to work flexible shifts aligned with U.S. CST hours.

● Customer-focused with a strong commitment to service excellence.

● Able to manage multiple tasks, prioritize effectively, and thrive in a fast-paced environment.

Responsibilities:

● Contact end patients and their employers and attorney representatives in the US to gather information to complete the claim.

● Analyze and evaluate complex claims payments using end Client's proprietary software, systems and tools.

● Use payment documentation provided by payers to determine if the medical provider has been reimbursed and perform accurate and timely data entry.

● Conduct timely and thorough telephone follow-up with payers and other responsible parties to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.

● Prepare correct complex claim initial bill packet or appeal letter using the end Client's systems tools and submit with all necessary supporting documentation to insurance companies.

● Assist in obtaining supporting claim documentation, appropriately compiling billing packets, and filing insurance claims.

● File and handle confidential documentation and Patient Health Information (PHI); able to adhere and follow all Health Insurance Portability and Accountability Act (HIPAA) mandated guidelines to safeguard data privacy and medica information.

● Meet or exceed Client's monthly Quality Audit metric and Production standard targets consistently.

● Collaborate well with other TES team members to improve team efficiency.

● Assist with operational research by highlighting process areas of improvement.

● Other duties as required.

Education:

● Diploma / Bachelor's Degree in any discipline, or 3+ years of work experience in US HC BPO

Experience:

● Experience working for a US based BPO OR US healthcare insurance industry experience OR a similar experience recommended

● Competent in MS Office Suite and Windows applications.

Skills and Prerequisites:

● Pass English Online Tool Assessment – oral and written – India EFT equivalent in Philippines

● Strong verbal communication skills in English.

● Fast and accurate typing skills while maintaining a conversation.

● Multitasking of data entry while conversing with Client contacts and insurance companies and other responsible parties.

● Ability to professionally and confidently communicate to outside parties via phone, email and fax.

● Ability to handle large volumes of work while maintaining attention to detail.

● Ability to work in a fast-paced environment.

● Work under limited supervision, manage multiple tasks and prioritize assignments within limited time constraints.

● Effectively communicate issues/problems and results that impact timelines for project completion.

● Ability to interact professionally at multiple levels within the organization.

● Timely and regular attendance.

Job Type: Full-time

Pay: Php50, Php80,000.00 per month

Benefits:

• Health insurance

Application Question(s):

• How many years of experience in Revenue Cycle Management?

Work Location: In person