Deskripsi Pekerjaan
Join our dynamic healthcare team as an RCM Blended Senior Specialist in Alabang, Metro Manila. This pivotal role bridges clinical documentation excellence with strategic utilization management to drive financial sustainability. You'll ensure regulatory compliance, maximize reimbursement accuracy, and proactively prevent claim denials through meticulous documentation reviews and process optimization. Perfect for professionals passionate about transforming healthcare revenue cycles while maintaining patient-centric care standards. Enjoy competitive compensation, professional development opportunities, and a collaborative work environment in one of Metro Manila's key business districts.
Tanggung Jawab
- Conduct comprehensive clinical documentation reviews to ensure coding accuracy and regulatory compliance
- Optimize utilization management processes to maximize reimbursement efficiency
- Analyze claim denials and implement corrective action plans
- Collaborate with clinical teams to resolve documentation gaps
- Develop and maintain RCM workflows aligned with industry standards
- Monitor key performance indicators and report on revenue cycle health
- Train staff on documentation best practices and compliance requirements
Kualifikasi
- Bachelor's degree in Health Administration, Business, or related field
- 5+ years of revenue cycle management experience
- Certification in RCM or healthcare compliance preferred
- Expertise in ICD-10/CPT coding and documentation standards
- Strong analytical skills with attention to detail
- Proficiency in EHR systems and RCM software
- Experience in utilization review and denial management
- Knowledge of Philippine healthcare regulations and policies