Revenue Cycle Denials Specialist: Maximize Reimbursement

Sysgen RPO, Inc.; Metro Manila; On-site; PHP 279,000 - 446,000; Full time

Job summary

Sysgen RPO, Inc. is seeking a Medical Billing Specialist for direct hire on-site in Ortigas, Pasig City. The role focuses on denial management within the healthcare revenue cycle to maximize reimbursement.

The ideal candidate has at least two years of experience in denial management, a clinical/healthcare background, and proficiency with EHR and billing systems. CPB/CRCR certification is a plus.

Qualifications

• Minimum 2 years experience in healthcare revenue cycle denial management.
• Understanding of ICD-10-CM, CPT, HCPCS, and medical necessity guidelines.
• Experience with EHR and billing systems.
• College graduate; CPB/CRCR certification is a plus.

Responsibilities

• Review denied, rejected, and underpaid claims to identify root causes.
• Research payer policies and guidelines to support appeals.
• Prepare and submit first- to third-level appeals with documentation.
• Follow up with insurers to ensure timely adjudication.
• Track denial trends and help reduce revenue leakage.

Skills

Denial management

Revenue cycle

Analytical skills

Attention to detail

Education

Bachelor’s degree or higher

Tools

EHR systems

Billing software

Excel

Payer portals

Job description

Sysgen RPO, Inc. is seeking a Medical Billing Specialist for direct hire on-site in Ortigas, Pasig City. The role focuses on denial management within the healthcare revenue cycle to maximize reimbursement.

The ideal candidate has at least two years of experience in denial management, a clinical/healthcare background, and proficiency with EHR and billing systems. CPB/CRCR certification is a plus.