RCM Specialist

Global Finance Teams; Makati; On-site; PHP 400,000 - 640,000; Full time

Job summary

Global Finance Teams in the Philippines seeks a Revenue Cycle Management (RCM) Specialist for a full-time role. The focus is on optimizing revenue cycle processes to ensure accurate billing and timely reimbursement.

You will manage end-to-end processes including patient registration, insurance verification, charge capture, claims submission, payment posting, and AR follow-up while monitoring KPIs to identify improvement opportunities and ensure payer compliance.

Responsibilities

• Manage end-to-end revenue cycle processes including patient registration and insurance verification.
• Handle charge capture, claims submission, payment posting, and AR follow-up.
• Monitor KPIs such as days in AR, claim denial rates, and collection percent.
• Identify trends and improvement opportunities to maximize revenue.
• Ensure compliance with payer requirements and healthcare regulations.

Job description

Revenue Cycle Management (RCM) Specialist

Full Time Position

Position Overview

We are seeking a highly motivated and detail-oriented Revenue Cycle Management (RCM) Specialist to join our dynamic healthcare finance team. This full-time position plays a critical role in optimizing our revenue cycle operations, ensuring accurate billing processes, and maintaining the financial health of our healthcare organization. The ideal candidate will possess a unique blend of administrative expertise, financial acumen, and comprehensive healthcare industry knowledge to drive efficiency and maximize revenue collection while maintaining compliance with healthcare regulations.

Key Responsibilities

Revenue Cycle Operations

• Manage end-to-end revenue cycle processes including patient registration, insurance verification, charge capture, claims submission, payment posting, and accounts receivable follow-up
• Monitor and analyze key performance indicators (KPIs) such as days in accounts receivable, claim denial rates, collection rates, and net revenue to identify trends and improvement opportunities
• Process and submit clean claims to insurance companies and government payers within established timeframes to ensure timely reimbursement
• Investigate and resolve claim denials, rejections, and underpayments through effective appeals and resubmission processes
• Conduct regular audits of billing and coding practices to ensure accuracy and compliance with payer requirements