RCM Operations Leader: Drive Revenue, Denials & Compliance

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 1,000,000 - 1,600,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking an experienced RCM Operations Manager to lead end-to-end Revenue Cycle Management operations in the Philippines.

You will drive operational excellence, oversee daily RCM functions, and manage high-performing teams to maximize revenue while ensuring regulatory compliance. You will monitor KPIs such as clean claim rate, denial rate, days in A/R, and authorization turnaround times, identifying bottlenecks and implementing improvements.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or related field.
• Minimum of 5 years of leadership experience in Revenue Cycle Management.
• Strong knowledge of insurance verification, prior authorization, medical billing, claims processing, accounts receivable management, denial management, and payment posting.

Responsibilities

• Manage daily operations of the Revenue Cycle Management department
• Lead and develop RCM supervisors, team leads, and staff to achieve operational goals
• Monitor and improve KPIs including clean claim rate, first-pass resolution rate, days in A/R, denial rate, collection rate, and authorization turnaround times
• Identify operational bottlenecks and implement process improvements
• Develop strategies to maximize reimbursement and reduce claim denials
• Collaborate with clients, providers, payers, and cross-functional teams to resolve escalated revenue cycle issues
• Ensure compliance with HIPAA, payer regulations, and company policies
• Analyze operational reports and present insights and recommendations to senior leadership
• Support workforce planning, forecasting, and resource allocation
• Lead training, coaching, and performance management initiatives

Skills

Leadership

Analytical skills

Communication

Stakeholder management

Excel analytics

EMR/EHR

Healthcare regulations

RCM certs

Education

Bachelor’s degree in Healthcare Administration

Tools

Practice management systems

EMR/EHR platforms

Reporting tools

Job description

CF Solutions Philippines Inc. is seeking an experienced RCM Operations Manager to lead end-to-end Revenue Cycle Management operations in the Philippines.

You will drive operational excellence, oversee daily RCM functions, and manage high-performing teams to maximize revenue while ensuring regulatory compliance. You will monitor KPIs such as clean claim rate, denial rate, days in A/R, and authorization turnaround times, identifying bottlenecks and implementing improvements.