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Pavago
Finance & Accounting 1d ago

Medical Billing Account Manager – Revenue Cycle Management (RCM) | Remote

Pavago
PhilippinesPhilippines
Full-time
Not Disclosed
Mid-Level

Job Description

Key Skills Required

Master these to land this role

Denial ManagementEHR SystemsClaims ManagementRevenue Cycle ManagementMedical Billing

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At Pavago, one of our clients is hiring an experienced Medical Billing Account Manager to support day-to-day Revenue Cycle Management (RCM) operations and ensure accurate, timely reimbursement across assigned client accounts.

This is an execution-focused role for a highly organized medical billing professional who can independently manage claim submissions, denial resolution, insurance follow-ups, collections, EOB/ERA review, and account management.

You’ll work within established billing workflows, manage high volumes of claims, communicate with insurance carriers and clients, and help ensure outstanding balances are resolved efficiently.

Medical Billing & Revenue Cycle Management

  • Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify:
    • Payment discrepancies
    • Claim denials
    • Rejections
    • Underpayments
    • Non-payment reasons
  • Analyze, investigate, and resolve claim denials and rejections
  • Review claims for proper diagnosis and procedure code relationships
  • Apply appropriate billing modifiers to support accurate claim adjudication
  • Perform claims scrubbing and quality assurance before submission
  • Submit:
    • Initial claims
    • Corrected claims
    • Secondary claims
  • Follow payer-specific submission requirements
  • Manage claim queues and prioritize follow-up activities
  • Maintain accurate billing records, claim notes, and account documentation
  • Follow up promptly on unpaid, rejected, or underpaid claims

Denial Management & Claims Follow-Up

  • Investigate the root causes of denied and rejected claims
  • Determine appropriate next steps for claim resolution
  • Correct billing or claim information where required
  • Track unresolved claims through final resolution
  • Follow up consistently with insurance carriers
  • Monitor claim status and reimbursement timelines
  • Help reduce preventable denials and delayed payments
  • Maintain clear documentation of all follow-up activities

Account Management & Insurance Follow-Up

  • Research payer portals and insurance websites to resolve claim issues
  • Obtain claim status and payment updates from insurance carriers
  • Communicate with payers regarding billing and reimbursement inquiries
  • Support client account management and respond to billing-related questions
  • Monitor aging accounts and support collections activities
  • Maintain consistent communication with clients and internal stakeholders
  • Ensure outstanding billing issues are followed through to resolution

Quality & Compliance

  • Maintain accuracy and compliance with payer guidelines and billing requirements
  • Meet established:
    • Productivity targets
    • Quality standards
    • Turnaround-time expectations
  • Maintain accurate and complete billing documentation
  • Identify recurring billing trends and potential process issues
  • Recommend practical improvements where appropriate
  • Work independently while maintaining a high level of accountability and accuracy

Requirements

  • Previous professional experience in Revenue Cycle Management (RCM)
  • Hands-on medical billing experience in a production environment
  • Strong knowledge of:
    • Claim submission
    • Denial management
    • Claims follow-up
    • Collections
  • Ability to read and interpret EOBs and ERAs
  • Experience reviewing diagnosis and procedure code relationships
  • Knowledge of billing modifiers and claims scrubbing processes
  • Experience working with insurance payer portals and medical billing systems
  • Strong organizational and time-management skills
  • Strong analytical and problem-solving abilities
  • Excellent written and verbal English communication skills
  • Ability to independently manage billing responsibilities with minimal supervision
  • Ability to maintain accuracy while managing a high volume of claims
  • Previous remote work experience preferred
  • Availability during standard U.S. business hours

Preferred Qualifications

  • Experience in high-volume medical billing environments
  • Experience supporting Texas-based medical practices
  • Experience with insurance verification
  • Experience managing client billing accounts
  • Strong background in denial resolution and collections
  • Experience working directly with insurance carriers and payer portals

EHR & Practice Management Systems

Experience with one or more of the following is highly preferred:

  • eClinicalWorks
  • Aprima
  • Medisoft
  • Veradigm
  • Nextech
  • CureMD
  • Office Practicum
  • NextGen

What Makes You a Strong Fit

You’ll likely thrive in this role if you:

  • Have extensive hands-on experience with medical billing and RCM workflows
  • Can independently resolve claim denials and payment issues
  • Understand the full process from claim submission through reimbursement
  • Are comfortable interpreting EOBs, ERAs, codes, and payer responses
  • Know how to prioritize aging and outstanding claims
  • Can manage a high volume of claims without sacrificing accuracy
  • Follow up persistently until billing issues are resolved
  • Communicate effectively with clients, insurance providers, and internal teams
  • Take ownership without requiring constant supervision
  • Thrive in a remote environment and consistently meet productivity expectations

What a Typical Day Looks Like

Your day may begin by reviewing claim queues, EOBs, ERAs, and aging accounts to identify claims requiring immediate attention.

Throughout the day, you’ll submit and review claims, resolve denials, follow up with insurance carriers, research payer requirements, update billing documentation, and monitor outstanding balances across assigned accounts.

You may also communicate with clients regarding billing questions, investigate underpayments, update claim notes, and identify recurring issues that could be affecting reimbursement.

In short: you keep the revenue cycle moving by ensuring claims are accurate, denials are resolved, outstanding balances are followed up on, and payments are collected efficiently.

Key Metrics for Success

  • Clean and accurate claim submissions
  • Reduced claim denial and rejection rates
  • Timely resolution of denied claims
  • Improved claims turnaround time
  • Consistent follow-up on unpaid and underpaid claims
  • Aging accounts actively managed
  • Improved collections and reimbursement
  • Accurate account and claim documentation
  • Achievement of productivity and quality targets
  • Strong client account management
  • Reduced outstanding claim backlog
  • Consistent compliance with payer requirements

Why This Role Stands Out

  • Hands-on ownership across the medical billing and RCM lifecycle
  • Direct impact on reimbursement and revenue performance
  • Exposure to multiple payer portals and billing systems
  • Opportunity to manage client accounts independently
  • Work across claims, denials, collections, and insurance follow-up
  • Fully remote working environment
  • Career growth opportunities into:
    • Senior Medical Billing Account Manager
    • Senior RCM Specialist
    • RCM Team Lead
    • Medical Billing Manager
    • Revenue Cycle Manager

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Pavago is a global offshore recruitment agency that specializes in connecting businesses with elite, pre-vetted remote talent. The company helps organizations build high-performing teams while significantly reducing labor costs—often by up to 70% compared to traditional onshore hiring. Sourcing primarily from regions like Latin America, Pakistan, and South Africa, Pavago places candidates in a wide variety of roles, including sales, marketing, administration, finance, IT, engineering, and product design. Beyond just talent acquisition, Pavago acts as a full-service partner by managing payroll, ensuring legal compliance, and providing onboarding support and ongoing training to guarantee that new remote hires integrate seamlessly and succeed long-term.

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