Senior RCM Billing Specialist

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 670,000 - 1,004,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking an experienced Senior RCM Billing Specialist to join our healthcare operations team in the Philippines. The role focuses on U.S. healthcare medical billing, claims management, and revenue cycle optimization.

You will manage end-to-end billing, review and submit claims, monitor status, handle denials, and produce billing reports. Strong English communication and EMR/EHR proficiency required.

Qualifications

• Experience in U.S. healthcare medical billing and claims management.
• Strong knowledge of Revenue Cycle Management processes.
• Experience handling commercial, Medicare, Medicaid claims and denials.

Responsibilities

• Manage end-to-end medical billing and revenue cycle processes.
• Review, prepare, and submit clean claims to payers.
• Monitor claim status and follow-up on unpaid/underpaid claims.
• Investigate and resolve denied, rejected, or delayed claims.
• Identify discrepancies and implement corrective actions.
• Analyze EOBs and ERA reports.
• Process appeals and track resolutions.
• Ensure payer regulatory compliance.
• Collaborate with providers, coders, and healthcare teams to resolve issues.
• Generate and maintain billing performance reports.

Skills

U.S. healthcare billing

Revenue Cycle Management

Denial management

Claims submission

EOBs/ERAs

CPT/ICD-10/HCPCS

EMR/EHR systems

English communication

Analytics

Leadership/ Senior role

Job description

About the role

We are seeking an experienced Senior RCM Billing Specialist to join our growing healthcare operations team. The ideal candidate will have extensive experience in U.S. healthcare medical billing, claims management, and revenue cycle operations. This role is responsible for ensuring accurate claim submission, timely reimbursement, denial resolution, and overall optimization of the billing process.

Key responsibilities

• Manage end-to-end medical billing and revenue cycle processes
• Review, prepare, and submit clean claims to insurance payers
• Monitor claim status and perform follow-ups on unpaid or underpaid claims
• Investigate and resolve denied, rejected, or delayed claims
• Identify billing discrepancies and implement corrective actions
• Analyze EOBs (Explanation of Benefits) and ERA reports
• Process appeals and track claim resolutions
• Ensure compliance with payer regulations and industry standards
• Work closely with providers, coders, and other healthcare teams to resolve billing issues
• Generate and maintain billing performance reports

About you

• Minimum 4+ years of U.S. healthcare medical billing experience
• At least 2 years of experience in a senior or advanced billing role
• Strong knowledge of Revenue Cycle Management processes
• Experience handling commercial, Medicare, and Medicaid claims
• Extensive experience in denial management and appeals processing
• Proficient in reviewing EOBs, ERAs, and insurance payment posting
• Familiarity with CPT, ICD-10, and HCPCS coding concepts
• Experience using EMR/EHR and medical billing systems
• Strong analytical and problem-solving skills
• Excellent verbal and written English communication skills