Revenue Cycle Management Associate, Quezon City

Who we are?

ActionLabs is an IT service provider offering end-to-end IT solutions, including Managed Services, Cybersecurity, Infrastructure, Field Support, and moretailored to meet the needs of businesses across industries.

Job Summary

The Revenue Cycle Management Associate is responsible for managing and resolving denied, rejected, and unpaid insurance claims to support timely reimbursement and optimize revenue cycle performance. This role involves claims follow-up, payer communication, appeals processing, clearinghouse resubmissions, and coordination with healthcare providers and insurance companies to ensure accurate and efficient claims resolution.

Key Responsibilities

• Review, analyze, and resolve denied or rejected insurance claims.
• Contact insurance companies to verify claim status and appeal claim denials.
• Prepare, correct, and resubmit claims through clearinghouse systems.
• Perform accounts receivable (AR) follow-up for outstanding claims and unpaid balances.
• Coordinate with hospitals, clinics, providers, and insurance payers regarding billing and reimbursement concerns.
• Monitor claim adjudication, reimbursement, and payment status.
• Maintain accurate documentation of claim actions, payer communications, and appeal outcomes.
• Identify root causes of claim denials and recommend corrective actions to reduce recurring issues.
• Ensure compliance with client productivity, accuracy, and quality standards.
• Escalate complex claims, payer disputes, or unresolved billing issues when necessary.

Qualifications

• Bachelors degree preferred; equivalent work experience may be considered.
• Experience in revenue cycle management, medical billing, or healthcare claims processing.
• Knowledge of insurance claims, EOBs, denial management, and AR follow-up processes.
• Familiarity with clearinghouse systems and healthcare billing platforms.
• Understanding of CPT, ICD, and HCPCS coding basics is an advantage.
• Strong analytical, problem-solving, and communication skills.
• Ability to manage multiple claims and meet productivity targets in a fast-paced environment.
• Proficiency in MS Office and healthcare-related systems/tools.