Remote Patient Access & Revenue Cycle Specialist

Private Advertiser; Philippines; Remote; PHP 446,000 - 558,000; Full time

Benefits offered by this job

Work From Home

Sign on Bonus: 3 months

Job summary

Private Advertiser is seeking qualified healthcare professionals and experienced BPO/healthcare candidates to join our healthcare operations team supporting Patient Access, Benefits & Authorization, and Revenue Cycle Management (RCM). The role will support insurance verification, eligibility checks, prior authorizations, and medical billing, with a work-from-home setup and a sign-on bonus of 3 months.

Night shift may be required.

Qualifications

• High School diploma or equivalent required.
• At least 2 years of relevant healthcare experience in patient access, insurance verification, benefits verification, prior authorization, pre-certification, referrals, revenue cycle management, medical billing, or related operations.
• Experience in healthcare BPO, physician office, hospital, insurance, or healthcare environment is preferred.
• Orthopedic healthcare experience is strongly preferred.
• Knowledge of medical terminology, CPT, ICD-10, insurance processes, payer requirements, and healthcare workflows.
• Experience using EHR systems, payer portals, eligibility verification tools, and authorization platforms.
• Strong communication, customer service, organization, attention to detail, problem-solving, and time-management skills.
• Ability to manage multiple requests, work queues, and priorities in a fast-paced environment.
• Ability to work effectively with patients, providers, payers, and internal stakeholders.
• Team leadership/training/quality review experience is an advantage.
• Willingness to work onsite in Bridgetowne, Quezon City and on a night shift schedule.

Responsibilities

• Verify health insurance eligibility, coverage, benefits, network status, and provider participation.
• Review and accurately document insurance information and benefits in patient accounts.
• Process referrals and authorizations according to payer guidelines.
• Obtain prior authorizations and pre-certifications for procedures and services.
• Review provider orders, CPT/ICD-10 codes, and other required information for accuracy.
• Submit authorization requests through payer portals, vendor platforms, phone, or fax.
• Follow up with payers regarding pending requests and outcomes.
• Provide accurate patient financial responsibility estimates based on verified benefits.
• Maintain documentation of insurance information, authorizations, and communications.
• Manage assigned work queues and ensure timely completion per turnaround times.
• Communicate with patients, providers, payers, and internal stakeholders to resolve issues.
• Support patient access and continuity of care by resolving insurance-related delays.
• Handle escalated, complex, or urgent cases and coordinate resolutions.
• Monitor queues, productivity, quality, and service levels; support operations.
• Assist with coaching, mentoring, and training when needed.
• Identify workflow gaps and recommend process improvements.
• Assist with workload balancing, audits, reporting, and other activities.
• Ensure compliance with payer requirements and privacy standards.

Education

High School diploma or equivalent

Job description

Private Advertiser is seeking qualified healthcare professionals and experienced BPO/healthcare candidates to join our healthcare operations team supporting Patient Access, Benefits & Authorization, and Revenue Cycle Management (RCM). The role will support insurance verification, eligibility checks, prior authorizations, and medical billing, with a work-from-home setup and a sign-on bonus of 3 months.

Night shift may be required.