Deskripsi Pekerjaan
Are you a detail-oriented professional with a passion for healthcare finance? Optum is looking for a dedicated Revenue Cycle Management (RCM) Specialist to join our high-performing team in Metro Manila. In this role, you will be the backbone of our provider-side financial operations, ensuring that the revenue cycle remains efficient, accurate, and compliant.
You will be responsible for managing the end-to-end lifecycle of medical claims, tackling complex denials, and driving AR collections. This is an excellent opportunity for someone who excels at problem-solving, enjoys working with healthcare billing systems, and wants to build a career with a global leader in health innovation. If you are a proactive communicator who can reconcile billing discrepancies and navigate payer contracts with precision, we want to hear from you.
Tanggung Jawab
- Manage the end-to-end claims lifecycle, ensuring timely submission and accurate processing.
- Investigate, document, and resolve unpaid claims and denials through direct communication with insurance payers.
- Conduct thorough accounts receivable (AR) follow-ups to decrease aging reports and improve cash flow.
- Reconcile billing discrepancies by analyzing patient charts and provider-side contract terms.
- Maintain high-level proficiency in medical billing software and electronic health records (EHR).
- Collaborate with internal departments to rectify documentation errors preventing clean claim submission.
- Ensure compliance with healthcare regulations, HIPAA standards, and internal financial policies.
Kualifikasi
- Minimum of 1-2 years of experience in Revenue Cycle Management, medical billing, or healthcare collections.
- Solid understanding of the end-to-end revenue cycle, including coding, billing, and denial management.
- Excellent analytical skills with the ability to identify trends in claim denials and recommend process improvements.
- Strong interpersonal skills, with the ability to negotiate professionally with insurance representatives.
- High proficiency in Microsoft Excel and experience using RCM or EHR software platforms.
- Keen attention to detail and ability to work efficiently in a high-volume, performance-driven environment.
- Bachelor’s degree in Healthcare Management, Finance, Business Administration, or a related field is preferred.