Job Description
Are you an expert in Revenue Cycle Management (RCM) with a passion for optimizing medical billing processes? CF Solutions Philippines Inc. is looking for a detail-oriented Senior RCM Specialist to join our growing team in Eastwood, Metro Manila. In this role, you will play a pivotal part in maintaining financial health by ensuring accurate and efficient billing cycles for our U.S.-based healthcare clients.
We are seeking a seasoned professional who understands the complexities of the U.S. healthcare system and possesses the analytical skills to identify revenue leakage, manage complex claims, and lead process improvements. If you thrive in a fast-paced environment and take pride in your ability to resolve billing challenges, we want to hear from you.
Responsibilities
- Oversee the end-to-end revenue cycle management process, from patient registration to final claim settlement.
- Perform comprehensive audits on denied claims to identify root causes and implement effective corrective actions.
- Manage accounts receivable (AR) aging reports to ensure timely collections and minimize bad debt.
- Coordinate with insurance providers to resolve complex billing disputes and payment delays.
- Prepare detailed financial reports and key performance indicators (KPIs) for management review.
- Ensure full compliance with HIPAA regulations and other healthcare billing standards.
- Mentor junior billing staff and provide training on updated payer policies and billing software.
Qualifications
- Minimum of 5 years of hands-on experience in U.S. medical billing and revenue cycle management.
- In-depth knowledge of CPT, ICD-10, and HCPCS coding guidelines.
- Strong proficiency in utilizing various Electronic Health Record (EHR) and Practice Management systems.
- Demonstrated expertise in navigating payer portals and resolving claim denials.
- Excellent analytical and problem-solving skills with a high degree of accuracy.
- Strong verbal and written communication skills for professional interaction with U.S. clients.
- Ability to work independently and meet strict operational deadlines in a high-volume environment.