Senior Billing Specialist

CF Outsourcing Solutions; Philippines; On-site; PHP 800,000 - 1,200,000; Full time

Job summary

CF Outsourcing Solutions in the Philippines seeks a Senior Revenue Cycle Management Specialist to oversee the full RCM process, including insurance verification, charge capture, coding review, claims submission, and collections.

The role serves as SME and escalation point for payer, coding, or reimbursement issues, driving financial performance while ensuring compliance with payer regulations and industry standards.

Qualifications

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field.
• At least 5 years' hands-on U.S. medical billing and revenue cycle experience.
• Strong knowledge of insurance guidelines and denial management.
• Experience with EMR/EHR and billing platforms such as Athena, Kareo, eCW, DrChrono, or Epic.

Responsibilities

• Oversee claims processing and billing accuracy across the revenue cycle.
• Verify insurance coverage and manage prior authorizations.
• Manage denials, appeals, and accounts receivable.
• Post payments and reconcile accounts.
• Ensure compliance with payer regulations and industry standards.
• Prepare reports and drive process improvements.
• Collaborate with cross-functional teams to optimize workflows.

Skills

CPT, ICD-10, HCPCS coding

Analytical ability

Communication skills

Independent work

Process improvement

Attention to detail

Education

Bachelor's degree in Healthcare Administration

Bachelor's degree in Business

Bachelor's degree in Finance

Tools

Athena

Kareo

eCW

DrChrono

Epic

Job description

The Senior Revenue Cycle Management (RCM) Specialist is responsible for managing, optimizing, and
overseeing the full revenue cycle process across insurance verification, charge capture, coding review,
claims submission, denials management, and collections. This individual serves as the subject-matter
expert and escalation point for complex payer, coding, or reimbursement issues. The Senior RCM Specialist
helps drive financial performance and ensures compliance with industry standards and payer regulations.

Key Responsibilities

1. 1. Claims Processing & Billing Oversight
2. 2. Insurance Verification & Prior Authorizations
3. 3. Denials, Appeals, & A/R Management
4. 4. Payment Posting & Reconciliation
5. 5. Compliance & Quality Assurance
6. 6. Reporting & Process Improvement
7. 7. Cross-Functional Collaboration

Required Qualifications

• Bachelors degree in Healthcare Administration, Business, Finance, or
• Minimum of 5 years of hands-on experience in U.S. medical billing and revenue cycle management.
• Strong expertise in insurance guidelines, reimbursement methodologies, and denial management strategies.
• Experience with common EMR/EHR and billing platforms (e.g., Athena, Kareo, eCW, DrChrono,
  Epic).

Skills

• Knowledge of CPT, ICD-10, and HCPCS coding principles.
• Strong analytical, organizational, and problem-solving ability.
• Excellent written and verbal communication for working with payers and providers.
• Ability to work independently, prioritize workload, and lead process improvement initiatives.
• High accuracy and attention to detail.