Cliniqon
Employment Type: Full-Time (FTE) Work Arrangement: Philippines Remote Position Summary We are seeking a detail-oriented and proactive Revenue Cycle Specialist to support our home health and/or hospice client’s operations. This role is responsible for ensuring the accuracy and integrity of claims prior to billing, managing accounts receivable (AR), and resolving claim denials. The ideal candidate has strong analytical skills, a deep understanding of payer requirements, and a commitment to compliance and process improvement. Key Responsibilities Pre-Bill Auditing Conduct thorough pre-bill audits of Medicare, Medicaid, and commercial insurance claims. Review clinical, coding, and billing documentation for accuracy, completeness, and consistency across all records. Identify and correct discrepancies or errors prior to claim submission. Ensure compliance with payer-specific billing guidelines and regulatory Requirements . Accounts Receivable (AR) \& Denial Management Monitor and manage AR to ensure timely reimbursement. Research, analyze, and resolve denied or rejected claims. Prepare and submit appeals with appropriate supporting documentation. Track denial trends and recommend process improvements to reduce future denials. Reconcile payments and ensure accurate posting. Compliance \& Process Improvement Maintain up-to-date knowledge of Medicare, Medicaid, and private payer regulations. Collaborate with clinical, coding, and billing teams to improve documentation and billing accuracy. Support internal audits and compliance initiatives. Professional Development Demonstrate willingness to obtain a coding certification (e.g., CPC, COS-C, HCS-D) if not already certified. Required Qualifications Minimum of two (2\) years of experience in home health revenue cycle management. Proficiency with EHR/EMR platforms such as Kinnser, KanTime or Alora Plus. Strong understanding of: o Insurance claims processing o Medicare/Medicaid billing o Private insurance billing o Compliance regulations Demonstrated experience with: Claim denials, appeals, and payment reconciliation Familiarity with medical coding systems: o HCPCS, ICD-10, CPT Excellent communication, analytical, and problem-solving skills. Ability to work independently and manage multiple priorities in a fast-paced environment. Preferred Qualifications Experience working with Electronic Medical Record (EMR) systems. Knowledge of OASIS documentation and home health agency regulations. Prior experience in a high-volume billing environment. Coding certification (or willingness to obtain certification). Key Competencies High attention to detail and accuracy Strong organizational and time-management skills Critical thinking and root-cause analysis Collaborative mindset with cross-functional teams Please send resume to jjavinal@cliniqon.com if interested. Pay: Php35,000\.00 - Php45,000\.00 per month Benefits Additional leave Company events Health insurance Opportunities for promotion Paid training Pay raise Promotion to permanent employee Work from home Application Question(s): Are you able to start ASAP? How many years your experience in Home Health and Hospice billing? Work Location: Remote
Cliniqon
