Healthcare RCM Collections & Denials Specialist

Optum; Makati; On-site; PHP 279,000 - 469,000; Full time

Benefits offered by this job

Laptop provided

Total rewards package

Retirement plan

Medical plan (HMO) from day 1

Dental, medical, and optical reimburse

Life and disability insurance

Sick leave conversion

Tuition reimbursement

EAP

Annual merit increases

Job summary

Optum Philippines is seeking a collections specialist to manage healthcare unpaid claims in a high-volume setting. You will verify claim status with insurers, process payments, and educate customers on online filing and portal use.

The role emphasizes accuracy, effective communication, and problem solving while supporting policy and procedure improvements for optimal collections performance.

Qualifications

• 12 months of RCM AR follow-up and denial experience.
• Experience handling unpaid, underpaid, rejected, and denied claims.
• Strong appeal letter writing and documentation skills.
• Knowledge of payer guidelines, timely filing, and denial resolution.
• Ability to multi-task and learn multiple products/benefits.

Responsibilities

• Contract reading of payment dispute.
• Working on the Provider side.
• Checking with the insurance to verify claim status and collect unpaid claims.
• Process claims payment.

Skills

Analytical skills

Communication skills

Problem-solving

Multi-tasking

Windows PC proficiency

Education

Senior High School diploma

Tools

EPIC SYSTEM

Job description

Optum Philippines is seeking a collections specialist to manage healthcare unpaid claims in a high-volume setting. You will verify claim status with insurers, process payments, and educate customers on online filing and portal use.

The role emphasizes accuracy, effective communication, and problem solving while supporting policy and procedure improvements for optimal collections performance.