AR Denials & Revenue Recovery Specialist

ADEC Innovations; Muntinlupa; On-site; PHP 335,000 - 580,000; Full time

Benefits offered by this job

Free shuttle

15% Night Differential

HMO DAY1 with FREE one dependent

Sleeping quarters with lactation room

Employee referral bonus

Healthy working environment

Free webinars and trainings

Job summary

ADEC Innovations in Alabang, Muntinlupa City, Philippines, is seeking a detail-oriented RCM AR professional to support the recovery of outstanding medical claims. You will analyze denials, research documentation, and prepare corrected submissions to improve revenue cycle performance.

Applicants should have 2+ years in healthcare RCM AR, familiarity with payer portals (Availity, Optum, Medicare), and strong communication and problem-solving skills to work with cross-functional teams.

Qualifications

• Graduate of a 4-year college degree.
• Minimum of 2+ years of RCM AR experience in healthcare BPO.
• Knowledge of commercial, HMO, Medicare/Medicaid payer requirements.
• Experience using payer portals such as Availity, Optum, Medicare, Evicore.

Responsibilities

• Review and resolve outstanding claim accounts focusing on denied claims across payers and regions.
• Analyze account history and research patient charts to support resolution.
• Investigate and follow up on denied claims, addressing coding discrepancies or contract issues.
• Initiate and manage appeals for denied claims and resubmit corrected claims.
• Communicate denial trends to leadership and support process improvements.
• Ensure timely processing of payments and documentation of all payments and denials.
• Review remittance advice and investigate underpayments or overpayments.
• Perform additional AR tasks and support other departmental responsibilities.

Skills

RCM AR experience

Denial management

payer knowledge

Communication skills

Problem solving

Education

4-year college degree

Tools

Availity

Optum

Medicare portals

EPIC

Job description

ADEC Innovations in Alabang, Muntinlupa City, Philippines, is seeking a detail-oriented RCM AR professional to support the recovery of outstanding medical claims. You will analyze denials, research documentation, and prepare corrected submissions to improve revenue cycle performance.

Applicants should have 2+ years in healthcare RCM AR, familiarity with payer portals (Availity, Optum, Medicare), and strong communication and problem-solving skills to work with cross-functional teams.