DME Back Office Specialist - Healthcare RCM (US Nights)

iScale Solutions; Makati; On-site; PHP 335,000 - 502,000; Full time

Job summary

iScale Solutions, in Makati City, Philippines, is building a talent pool for DME/Healthcare Back Office Support roles to assist U.S. healthcare providers. Roles include patient intake, eligibility verification, prior authorization, billing, and documentation with emphasis on accuracy and compliance.

We seek professionals with DME/HME or healthcare administration experience who can work US-aligned night shifts and coordinate across patients, providers, and payers while maintaining confidentiality.

Qualifications

• Experience in DME/HME and US healthcare BPO.
• Experience with EMR/EHR systems preferred.
• Experience with DME billing and Revenue Cycle Management (RCM).
• Ability to meet productivity and quality targets.
• Attention to accuracy and confidentiality in healthcare data.

Responsibilities

• Process patient referrals and DME orders; verify patient and prescription information, review documents, and coordinate missing requirements.
• Verify eligibility, benefits, and DME coverage with Medicare, Medicaid, and commercial payers; submit and follow up on authorization requests.
• Review prescriptions, SWOs, CMNs, and supporting documentation to ensure completeness and payer compliance.
• Prepare and submit DME claims, use HCPCS codes/modifiers, monitor status, and support posting, AR/denials/appeals.
• Communicate with patients, providers, and payers regarding documentation, coverage, authorizations, billing, and order status.
• Maintain accurate, confidential records across healthcare systems.

Skills

Accuracy

Attention to detail

Analytical thinking

Problem solving

Ownership

Communication

Patient/customer service orientation

Confidentiality

Tools

Brightree

NikoHealth

Availity

Office Ally

EMR/EHR systems

DME/HME platforms

Insurance payer portals

CRM & ticketing systems

Job description

iScale Solutions, in Makati City, Philippines, is building a talent pool for DME/Healthcare Back Office Support roles to assist U.S. healthcare providers. Roles include patient intake, eligibility verification, prior authorization, billing, and documentation with emphasis on accuracy and compliance.

We seek professionals with DME/HME or healthcare administration experience who can work US-aligned night shifts and coordinate across patients, providers, and payers while maintaining confidentiality.