Job description
Join Optum, a global health services leader, as a Healthcare Collections Claim Specialist (End-to-end RCM) in Metro Manila. This provider-side role focuses on managing contracts, unpaid claims, denials, AR collections, billing reconciliation, and resolution to support efficient cash flow for our healthcare partners.
In this end-to-end RCM position, you will own the lifecycle of claims from submission to settlement, ensuring accuracy, timeliness, and compliance with payer requirements. You will collaborate with providers, patients, and payers to resolve complex issues and maximize reimbursement while upholding the highest standards of privacy and data integrity.
This role offers a dynamic, metrics-driven environment where effective communication, problem-solving, and attention to detail are essential. You will be empowered to identify process improvements, reduce days in AR, and contribute to a best-in-class revenue cycle operation across Metro Manila facilities.
Ideal candidates are customer-service oriented, proficient with medical billing tools, and comfortable navigating denial codes and payer policies. If you are ready to make an impact in healthcare administration and revenue cycle management, apply today.
Responsibility
- End-to-end management of provider-based revenue cycle processes, from contract setup to claim resolution.
- Monitor and follow up on unpaid claims, denials, and aging AR to maximize collection timelines.
- Review, post, and reconcile billing data against submitted claims and payer remittance.
- Communicate with payers, providers, and patients to obtain information, resolve discrepancies, and appeal denials when required.
- Collaborate with internal teams to resolve issues and implement process improvements that reduce denials and shorten cash cycles.
- Maintain HIPAA compliance, privacy, and data integrity while handling sensitive information.
- Prepare and analyze AR and collection reports to support performance tracking and decision making.
- Adhere to company policies and regulatory guidelines while delivering high-quality service in a fast-paced environment.
Qualification
- Minimum 1-2 years of experience in healthcare collections or end-to-end RCM (Philippines market preferred).
- Strong knowledge of medical billing, CPT/ICD coding, payer rules, and denial management.
- Proven experience with accounts receivable, collections, and claim status follow-ups.
- Excellent written and verbal communication and negotiation skills.
- Detail-oriented with strong accuracy in data entry and financial reconciliation.
- Proficiency in MS Excel and experience with healthcare billing software or CRM platforms.
- Ability to work independently and in a team, manage multiple priorities, and meet deadlines.
- Professional, reliable, with a customer-service mindset and strong problem-solving ability.