RCM Specialist

Position Summary

The Revenue Cycle Specialist is responsible for delivering exceptional patient financial services and providing comprehensive revenue cycle support. This role manages patient billing inquiries, payment processing, insurance follow-up, collections support, refund administration, and related financial activities to enhance patient satisfaction, optimize revenue recovery, and support overall operational efficiency.

Key Responsibilities

Patient Financial Services

• Handle patient billing inquiries via phone and approved communication channels.
• Explain statements, insurance payments, denials, and patient balances.
• Set up payment plans and process payments.

Insurance & Patient Follow-Up

• Obtain updated insurance information and resolve COB issues.
• Notify patients of denials and outstanding balances.
• Conduct outbound outreach regarding account resolution.

Payment Plans & Collections

• Monitor payment plans and follow up on missed payments.
• Review collection accounts and perform final collection attempts.
• Coordinate account placements with collection agencies.

Refund Administration

• Process approved patient and insurance refunds.
• Resolve refund discrepancies and support escheatment activities.

Administrative Support

• Review credit balances and post applicable charges.
• Maintain accurate documentation and correspondence records.
• Complete assigned revenue cycle administrative tasks.

Work Set Up: Work Onsite in Eastwood, Quezon City

Required Qualifications

• Minimum 1 year of experience in Revenue Cycle Management (RCM), Medical Billing, Patient Financial Services, Accounts Receivable, or Healthcare Collections.
• Strong knowledge of medical billing, insurance claims, EOBs, denials, and patient balances.
• Experience handling patient billing inquiries and payment arrangements.
• Familiarity with Coordination of Benefits (COB) and insurance verification processes.
• Proficiency in electronic health records (EHR), practice management systems, and Microsoft Office applications.
• Excellent verbal and written English communication skills.
• Strong customer service, problem-solving, and organizational skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Knowledge of HIPAA regulations and patient data privacy requirements.