Revenue Cycle Specialist

1 week ago

Cebu City, Central Visayas, Philippines RemoteRaven Full time

Job Title: Medical Billing Specialist | Revenue Cycle Specialist

Location: Remote

Work Setup: Full-time | Long-term

About the Role

We are hiring an experienced and detail-oriented Medical Billing Specialist to join our Revenue Cycle Management (RCM) team. The ideal candidate has strong experience in claims review, denial resolution, payment reconciliation, and maintaining clean claims within a clinical or DME environment. Accuracy, ownership, and strong analytical skills are essential to ensure consistent reimbursement and healthy accounts receivable.

Key Responsibilities

Claims & Payment Management

  • Review and resolve eligibility issues daily to ensure claims have accurate insurance details
  • Verify and maintain accuracy of insurance IDs and uploads in Phreesia
  • Monitor and clear HOLD and MGRHOLD claims on a daily basis
  • Review and resolve claims aged 90+ days, focusing on accounts receivable reduction
  • Work on unpostables and manage correspondence dashboards for timely posting
  • Support pre-collections in Phreesia when needed

Payment Reconciliation

  • Review and reconcile Optum Pay and ECHO payments for the past 13 months through current
  • Conduct Zero Pay Report validation against prior month Athena adjustments
  • Assist in reconciling DME and Square payment reports as part of monthly financial tracking

Remote Therapeutic Monitoring (RTM) Billing

  • Manage monthly RTM billing with the billing lead
  • Bill CPAP and INSPIRE patients for setups, downloads, and counseling
  • Maintain accurate RTM logs and billing documentation

Reporting & Financial Analysis

Prepare and submit monthly financial reports, including:

  • Charges and payments posted in Athena
  • Nurse Practitioner productivity and patient volume
  • Clean claim and denial rates
  • RTM payments
  • Zero Pay tracking
  • DME and Square payment tracking

Qualifications

  • 2+ years of medical billing or RCM experience
  • Strong knowledge of claims processing, eligibility verification, and denial management
  • Experience with AthenaHealth, Phreesia, or other EHR/PM platforms
  • Skilled in interpreting EOBs, payment reporting, and denial codes
  • High attention to detail and accuracy
  • Strong Excel and data entry skills
  • Analytical, communicative, and able to work independently

How to Apply

Send your resume to

Subject line format:

JobStreet Applicant | Medical Billing Specialist/Revenue Cycle Specialist | Your Name

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