RCM Specialist

Job Description

Portiva started in 2009 with our mission to help Doctors and Medical Practitioners manage their practices better. Since then, Portiva has grown from a 3-person operation to one of the largest and most successful Medical and Dental Staff Providing Companies in the United States.

We are seeking an experienced and detail-oriented Revenue Cycle Management (RCM) Specialist with a background in infusion therapy billing. This role manages the full billing lifecycle—from claim creation through payment follow-up—ensuring timely and accurate reimbursement for infusion therapy services. Expertise in EMRs such as Tebra and comfort using phone-based applications for communication are essential.

This is a Work-from-home opportunity.

This is a full-time position, 30/40 hrs a week

The rate is $7 an hour or Php 45,000 to Php 61,000+ per month

A Revenue Cycle Management (RCM) Specialist plays a crucial role in ensuring smooth operations in a medical facility. Their responsibilities often include but not limited to:

• Claim Preparation & CodingAccurately assign ICD‑10, CPT, HCPCS codes to infusion therapy procedures and diagnoses; ensure clean, compliant claims ready for submission
• Pre‑AuthorizationObtain prior authorizations for infusion therapy services and verify patient insurance eligibility and benefits
• Claim SubmissionSubmit claims electronically via EDI or payer portals; address submission errors, rejections, and resubmit as needed
• Payment Posting & ReconciliationPost payments accurately using EOBs/ERAs, reconcile discrepancies, manage adjustments, and ensure accounts balance.
• Accounts Receivable & Denial ManagementMonitor aging reports, follow up on unpaid or denied claims, manage appeals, and work denials within timely cycles.
• Infusion Therapy Billing ExpertiseApply knowledge of infusion-specific reimbursement, including Medicare, Medicaid, commercial payers, and drug billing nuances.
• End-to-End RCM OversightOversee billing from start to finish, including analysis, reporting, and process improvement; maintain departmental KPIs like clean claim rate, denial rate, DSO.
• EMR ProficiencyUtilize EMRs such as Tebra (and others) for billing, documentation, and claim workflows.
• Phone App CommunicationUse mobile or phone-based tools for timely communication with payers, patients, and internal teams—handling inquiries, verifications, or appeals efficiently.
• Regulatory ComplianceAdhere to HIPAA, CMS, and payer-specific guidelines to maintain compliance and safeguard patient information.

Requirements and skills

• 2–5 years of medical billing experience, particularly in infusion therapy or outpatient clinical settings
• Demonstrated expertise in end-to-end revenue cycle processes: claim prep, submission, payment posting, AR, and denials.
• Coding: ICD‑10, CPT, HCPCS
• Pre‑authorization and payer portal workflows
• Experience with EMR systems (Tebra, AdvancedMD, etc.)
• Comfortable with phone apps for payer/patient communication.
• Excellent English speaking skills (both oral and written proficiency)
• Problem-solving and multitasking in fast-paced environments

If this sounds like you, please complete this form:

We will ONLY accept applications via the Google form above.

We will contact you within 3-7 days if you fit the requirements.

*Important Note*: Please make sure to check your spam or junk folders for the initial assessment invite. Sometimes, our emails may get filtered, and we wouldn't want you to miss this important step in the hiring process If you find our email there, be sure to move it to your inbox and mark it as "Not Spam" to ensure you receive all future emails from us directly in your inbox

Good luck

Job Type: Full-time

Pay: Php60, Php65,000.00 per month

Work Location: Remote