RCM Operations Specialist: Payer Setup & Denials

Fgcplus; Davao del Sur; On-site; PHP 446,000 - 781,000; Full time

Benefits offered by this job

Day 1 HMO

Competitive pay with incentives

13th month pay

Onsite medical support

Employee Engagement Events

Employee Referral Program

Skills training for development

Job summary

FGC+ is seeking an RCM Operations Specialist to ensure accurate payer configurations in the system and promptly resolve billing issues across commercial insurers, Medicare, Medicaid, and other payers. You will collaborate with billing and coding teams to fix errors and ensure seamless claim processing.

Responsibilities include setting up payer portals, reflecting contracts in billing, managing denials, and following up with denial management teams to optimize reimbursements while maintaining

Qualifications

• 2+ years of healthcare experience.
• Proficient in EHR systems.
• Experience with insurance portals such as Availity, Medicare, CoverMyMeds, and Optum.
• Experience with benefit verification and prior authorizations.
• Detail-oriented with accurate documentation.
• Excellent written and verbal communication.
• Knowledge of medical terminology.

Responsibilities

• Set up payer configurations accurately in the RCM system.
• Resolve billing issues related to payer contracts, claims submission, and payments.
• Work with billing and coding teams to correct billing errors.
• Ensure payer contracts reflect in the billing system, including terms and rates.
• Follow up on denials and rejections due to payer configuration errors.

Skills

Healthcare experience

EHR systems

Insurance portals

Benefit verification

Documentation

Communication skills

Medical terminology

Tools

Availity

Medicare

CoverMyMeds

Optum

Job description

FGC+ is seeking an RCM Operations Specialist to ensure accurate payer configurations in the system and promptly resolve billing issues across commercial insurers, Medicare, Medicaid, and other payers. You will collaborate with billing and coding teams to fix errors and ensure seamless claim processing.

Responsibilities include setting up payer portals, reflecting contracts in billing, managing denials, and following up with denial management teams to optimize reimbursements while maintaining