RCM Analyst

Work Location: Bridgetowne Quezon City
Work Arrangement: Onsite
Shift: Night Shift
Employment Type: Full-time

We are looking for a Revenue Cycle Management (RCM) Analyst to join our healthcare operations team. The role will support various Revenue Cycle functions to ensure accurate timely and efficient processing of healthcare accounts claims payments and related transactions.

The successful candidate will be responsible for researching and resolving account issues processing transactions reviewing claims and payment information and coordinating with internal teams and external stakeholders to support clean claims accurate reimbursement and overall revenue cycle performance.

• Perform assigned Revenue Cycle activities across areas such as charge entry eligibility and benefits authorization claims processing payment posting accounts receivable denials and reconciliation.
• Review patient insurance claim and account information for accuracy and completeness.
• Process and maintain healthcare accounts and transactions in accordance with established procedures.
• Research and resolve claim edits billing issues payment discrepancies denials and other account-related concerns.
• Review payer information remittances EOBs and other supporting documentation as applicable.
• Coordinate with internal teams healthcare providers payers and other stakeholders to obtain information and resolve outstanding issues.
• Monitor assigned work queues and accounts to ensure timely follow-up and resolution.
• Identify missing incomplete or inaccurate information that may impact claim submission payment or account resolution.
• Perform account and payment reconciliation as assigned and investigate discrepancies across systems.
• Maintain accurate and complete documentation of research actions taken and resolutions.
• Follow payer requirements healthcare billing guidelines company policies and established Revenue Cycle procedures.
• Identify recurring issues and communicate trends or process gaps to appropriate leadership.
• Support quality assurance audits process improvement initiatives and other RCM projects as assigned.
• Maintain patient confidentiality and appropriately handle protected health and financial information.

• At least 23 years of experience in Healthcare Revenue Cycle Management Medical Billing or a related healthcare operations role.
• Experience in one or more RCM functions such as:
  • Charge Entry
  • Claims Processing
  • Insurance Verification
  • Eligibility and Benefits
  • Prior Authorization
  • Payment Posting
  • Accounts Receivable
  • Denials and Appeals
  • Billing and Collections
  • Reconciliation
• Experience using EMR EHR practice management patient accounting or other healthcare systems.
• Working knowledge of healthcare insurance claims billing and reimbursement processes.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.
• Ability to research account issues and determine appropriate next steps.
• Strong organizational and time-management skills.
• Good written and verbal communication skills.
• Ability to work independently and manage multiple priorities in a high-volume environment.
• Willing to work onsite in Bridgetowne Quezon City and on a night shift.

• Experience supporting U.S. healthcare or U.S. medical billing operations.
• Experience with athenaOne Epic Cerner Meditech or other comparable healthcare systems.
• Familiarity with commercial insurance Medicare Medicaid Workers Compensation and other U.S. healthcare payers.
• Experience with payer portals such as Availity NaviNet or comparable platforms.
• Knowledge of CPT ICD-10 HCPCS modifiers EOBs ERAs and common healthcare billing processes.
• Medical billing coding or Revenue Cycle-related certification is an advantage.