Revenue Cycle Management (RCM) Specialist

UPTC; Cebu City; On-site; PHP 391,000 - 614,000; Full time

Job summary

UPTC is seeking an RCM Specialist to provide revenue cycle support for U.S. healthcare clients. Responsibilities include verification, claims processing, AR follow-up, denial management, and payer follow-up, using client workflows and multiple applications.

Strong attention to detail and independent work style are essential. The role requires a high school diploma, solid English communication, and prior BPO/healthcare operations experience.

Qualifications

• High school diploma or equivalent.
• Proficient English (B1-C2) with strong communication.
• Experience in BPO/healthcare operations and data entry.
• Strong typing and ability to multitask across multiple applications.

Responsibilities

• Process assigned revenue cycle activities per client requirements.
• Review patient and insurance information for accuracy.
• Verify insurance eligibility and benefits when assigned.
• Submit, correct, resubmit, and follow up on claims.
• Research unpaid, rejected, and denied claims.
• Follow up AR and document payer interactions.
• Review EOBs/ERAs and identify payments, adjustments, denials.
• Assist with payment posting and reconciliation when assigned.
• Identify billing issues delaying reimbursement and take corrective action.
• Maintain accurate account notes and documentation.

Skills

English proficiency

Typing

Data entry

CRM systems

Computer literacy

Attention to detail

Time management

Teamwork

Independent work

Fast-paced environment

Education

High school diploma

Job description

About the role

The RCM Specialist provides healthcare revenue cycle support to U.S. healthcare organizations, physician practices, hospitals, and other healthcare clients. The specialist performs administrative and financial activities across the revenue cycle, including insurance verification, claims processing, accounts receivable, payment posting, denial management, and payer follow-up. The RCM Specialist is responsible for accurately processing healthcare information, researching account issues, communicating with insurance payers when required, and following client-specific workflows to support timely and accurate reimbursement.

Key responsibilities

• Process assigned healthcare revenue cycle activities according to client requirements


• Review patient and insurance information for accuracy and completeness


• Verify insurance eligibility and benefits when assigned


• Perform claim-related activities, including claim submission, correction, resubmission, and follow-up


• Research unpaid, rejected, and denied claims


• Perform accounts receivable follow-up and document payer interactions


• Review EOBs and ERAs and accurately identify payments, adjustments, and denials


• Assist with payment posting and reconciliation activities when assigned


• Identify billing issues that may delay reimbursement and take appropriate corrective action


• Maintain accurate account notes and documentation

About you

• High school diploma or equivalent


• B1-C2 English proficiency, with strong verbal and written communication skills


• Previous BPO, contact center, shared-services, or healthcare operations experience


• Strong typing and data-entry skills


• Very good computer literacy and ability to work with multiple applications simultaneously


• Strong CRM and computer system skills


• Excellent attention to detail and accuracy


• Strong organizational and time-management skills


• Ability to work independently and as part of a team


• Ability to work in a fast-paced, metrics-driven environment