Deskripsi Pekerjaan
Are you a seasoned professional in healthcare revenue management? CF Solutions Philippines Inc. is looking for a Senior RCM Specialist to join our dynamic team. In this pivotal role, you will leverage your expertise in US medical billing to optimize our revenue cycle processes, ensuring maximum cash flow and operational efficiency. We are committed to delivering top-tier healthcare administrative services, and we need a leader who can drive accuracy and compliance in our billing operations.
As a key member of our finance and operations team, you will be responsible for complex billing tasks, team mentorship, and strategic process improvements. If you are passionate about the healthcare industry and possess a keen eye for detail, we want to hear from you.
Tanggung Jawab
- Oversee the entire revenue cycle management process, from patient registration to final claim payment.
- Analyze accounts receivable aging reports to identify trends, discrepancies, and delinquent accounts.
- Conduct thorough patient eligibility verification and insurance authorizations to minimize claim denials.
- Submit clean claims to US payers and manage the follow-up on unpaid or pending claims.
- Research, appeal, and resolve denied claims in accordance with payer guidelines.
- Mentor junior billing staff and ensure adherence to company SOPs and compliance standards.
- Collaborate with clinical and administrative departments to resolve billing disputes and improve documentation.
Kualifikasi
- Minimum of 5 years of hands-on experience in U.S. medical billing and revenue cycle management.
- In-depth knowledge of medical coding (ICD-10, CPT) and healthcare reimbursement methodologies.
- Proficiency in EMR/EHR systems (e.g., Epic, Cerner, AthenaHealth) and Practice Management Software.
- Strong analytical skills with the ability to interpret complex billing data and financial reports.
- Excellent written and verbal communication skills for effective payer correspondence.
- Self-motivated with the ability to work independently and meet tight deadlines.
- Knowledge of HIPAA regulations and healthcare privacy laws.