Senior RCM Specialist

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 800,000 - 1,200,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking a Senior Revenue Cycle Management Specialist to oversee the full revenue cycle—from insurance verification to denials management and collections—for U.S. payer accounts.

You will act as the subject-matter expert and escalation point for complex coding or reimbursement issues. The role requires a Bachelor's degree and at least five years of hands-on U.S. medical billing experience, with expertise in CPT/ICD-10/HCPCS, payer guidelines, and denial

Qualifications

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field.
• 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 EMR/EHR and billing platforms (e.g., Athena, Kareo, eCW, DrChrono, Epic).
• 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.

Responsibilities

• Claims Processing & Billing Oversight
• Insurance Verification & Prior Authorizations
• Denials, Appeals, & A/R Management
• Payment Posting & Reconciliation
• Compliance & Quality Assurance
• Reporting & Process Improvement
• Cross-Functional Collaboration

Skills

RCM Expertise

Denials management

Coding knowledge

EMR/EHR systems

Analytical skills

Payer communications

Process improvement

Education

Bachelor's degree in Healthcare Administration/Business/Finance

Tools

Athena

Kareo

eCW

DrChrono

Epic

Job description

About the role

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

• Claims Processing & Billing Oversight
• Insurance Verification & Prior Authorizations
• Denials, Appeals, & A/R Management
• Payment Posting & Reconciliation
• Compliance & Quality Assurance
• Reporting & Process Improvement
• Cross-Functional Collaboration

About you

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field
• 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)
• 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