Revenue Cycle Management

2 weeks ago

Quezon City, National Capital Region, Philippines Private Advertiser Full time $90,000 - $120,000 per year

Qualifications:

  • 5+ years of experience in the US healthcare industry with acute and ambulatory billing
  • 5+ years of experience in healthcare revenue cycle management services, with understanding of upstream and downstream
  • Worked as AR representative and effectively implemented the experiential learning in the new hire batches
  • In-depth knowledge of denial management and appeal writing for both administrative and clinical denials
  • In-depth knowledge of Acute and Ambulatory specialties with understanding of associated diagnosis, procedure and denials
  • Comprehensive knowledge of UB04 claim form component, including proper inpatient coding, revenue codes, procedure codes, and regulatory requirement
  • Familiarity with insurance guidelines (Medicare, Medicaid, commercial payers) and their plans
  • Expertise in handling inpatient claims and understanding payment methodologies- DRG classifications, bundled payment models)
  • Proficiency in understanding coding denials and code sets (ICD-10, CPT04, HCPCS) and understanding of medical records
  • Demonstrated ability to analyze AR claim as end to end and identify the root cause and faster resolution
  • Demonstrated ability to handle multiple geos – US/PR/PHL/IND
  • Proven solid analytical and problem-solving skills
  • Proven excellent communication and leadership abilities

Primary Responsibilities:

  • Successful implementation and management of the training department
  • Training fresher, existing and experienced colleagues for all scopes of work in backend business of RCM
  • Delivering training programs to employees using a variety of methods, including classroom instruction, e-learning and on-the-job training
  • Review training needs and performance monthly basis and perform focus group, conduct feedback and monitor progress of the batches till they become productive as 100%
  • Bottom quartile management
  • Plan and implement an effective training curriculum, content and automation
  • Collaborate with management to identify training needs (TNI or TNA) for all employees
  • Regularly connect with ops, quality and training to enhance the training and identify the area of improvement
  • Maintaining up-to-date knowledge of best practices in training and development and making recommendations for changes to training programs as required
  • Be able to raise or track new hire process credentials
  • Be able to work on the accounts for the aligned process to have hands-on experience for better for experiential training
  • Learn new or existing business as end to end and prepare or modifier the training curriculum
  • Be able to align themselves with organization or team or client culture and mission, vision and value
  • Be well equipped in handling in-person and virtual training
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

  • Revenue Cycle Management Specialist

    4 weeks ago

    Makati City, National Capital Region, Philippines Somewhere Full time

    RCM SpecialistLocation: Remote (PH)Compensation: $1,300 - $1,700 USD/monthIndustry: Dental / Healthcare Revenue Cycle ManagementSchedule: 8:00 AM - 5:00 PM CST (Monday to Friday) (Full-time, Monday-Friday)OverviewWe are seeking a detail-oriented and experienced RCM Specialist to support the credentialing, billing, and accounts receivable (AR) processes for...

  • Revenue Cycle Management Trainer

    2 weeks ago

    Makati City, National Capital Region, Philippines Optum Full time $104,000 - $130,878 per year

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers,...

  • Hotel Revenue Manager

    1 week ago

    Quezon City, National Capital Region, Philippines The Lind Hotels Full time $70,000 - $120,000 per year

    Revenue ManagementDevelop and execute pricing strategies to optimize revenue across all distribution channels.Analyze market trends, competitor performance, and customer demand to forecast future revenues accurately.Implement revenue management systems and tools to automate decision-making and optimize inventory.Monitor and evaluate the performance of...

  • Revenue and Reservations Manager

    2 weeks ago

    Quezon City, National Capital Region, Philippines The Lind Hotels Full time $80,000 - $120,000 per year

    Revenue ManagementDevelop and execute pricing strategies to optimize revenue across all distribution channels.Analyze market trends, competitor performance, and customer demand to forecast future revenues accurately.Implement revenue management systems and tools to automate decision-making and optimize inventory.Monitor and evaluate the performance of...

  • Revenue Operations Lead

    4 days ago

    Mandaluyong City, National Capital Region, Philippines Birmingham Holdings Inc. Full time ₱900,000 - ₱1,200,000 per year

    Work Arrangement – We Commit to Work-Life BalanceHybrid setup: 1x per week in-office (Mandaluyong), 4days remote WFHTraining period: First 30 days in-office, Monday to FridayWork hours: 8:00 AM to 5:00 PMAbout the RoleWe are seeking a detail-oriented and strategic Revenue Operations Lead to join our dynamic team. As the Revenue Operations Lead, you will be...

  • Revenue Audit

    6 days ago

    Makati City, National Capital Region, Philippines Green Pasture People Management Inc. Full time ₱240,000 - ₱264,000 per year

    Examine and verify documents related to income and revenue for an organization or client.Job Type: Full-timePay: Php20, Php22,000.00 per monthWork Location: In person

  • Revenue Collection Assistant

    1 week ago

    Quezon City, National Capital Region, Philippines STRADCOM Corporation Full time ₱104,000 - ₱130,878 per year

    Duties and ResponsibilitiesPrepares daily and periodical collection and revenue report of Auxiliary projects;Maintains accurate revenue records for monitoring and operational use;Acknowledges deposits of clients, conducts due diligence necessary, and processes for effecting of deposit in the clients' respective accounts;Communicates account balances to...

  • Revenue Officer

    1 week ago

    Makati City, National Capital Region, Philippines Private Advertiser Full time ₱900,000 - ₱1,200,000 per year

    Job SummaryThe Revenue Officer is responsible for managing and optimizing the hotel's revenue streams by ensuring accurate pricing, inventory management, and consistent monitoring of performance. This role oversees all Online Travel Agency (OTA) channels, ensuring competitive positioning, timely posting of rates and promotions, and accurate room...

  • URGENT Hiring RCM/ AR Team Leader for Healthcare_Acute and Ambulatory_QC

    2 weeks ago

    Quezon City, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time ₱600,000 - ₱1,200,000 per year

    Completed 2 years in CollegeWith at least 2 year of BPO Team Lead experience handling Revenue Cycle Management (RCM) AccountKnowledgeable in Accounts Receivable - Healthcare Account, Appeals Denial, Payment and Claims Processing for leadership level experience in Hospital revenue cycle, with expertise in billing and collectionsCan Start ASAPWilling to work...

  • Revenue Management Analyst

    2 weeks ago

    Makati City, National Capital Region, Philippines OPENLANE Full time ₱900,000 - ₱1,200,000 per year

    Who We Are:At OPENLANE we make wholesale easy so our customers can be more successful.We're a technology companybuilding the world's most advanced—anduncomplicated—digitalmarketplace for used vehicles.We're a data companyhelping customers buy and sell smarter with clear, actionable insights they can understand and use.And we're an innovation...