RCMS US Healthcare QC Analyst Clinical Coding Denials AC Manila

The Opportunity

Join our Acceleration Center Manila and help shape the future of business for our diverse client portfolio across geographies and jurisdictions. You’ll work at the heart of global teams across Advisory, Assurance, Tax and Business Services—solving real client challenges through connected collaboration. We’ll help you grow your skills so you can go further. With hands-on learning, cutting-edge tools and an inclusive culture, this is your opportunity to do inspiring work that makes a difference—every day.

As an RCMS US Healthcare QC Analyst (Clinical/Coding Denials) at PwC Acceleration Center Manila, you will engage in providing consulting services to optimize operational efficiency and effectiveness. You will work closely with clients to analyze operational processes, identify areas for improvement, and develop strategies to enhance productivity, quality, and efficiency. Within our Business & Supply Chain Operations practice, you will focus on developing innovative solutions and offering guidance on implementing technology solutions, process automation, and operational excellence frameworks.

As an Associate, you will be driven by curiosity and contribute to client engagement and projects while developing your skills and knowledge to deliver quality work. You will adapt to working with a variety of clients and team members, each presenting unique challenges and scope. This role emphasizes learning, adaptability, and teamwork, where you will take ownership and consistently deliver quality work that drives value for our clients and success as a team. In this role at PwC, you will build a brand for yourself, opening doors to more opportunities, and navigate through the firm, enhancing your personal growth and technical skills.

Responsibilities

• Analyzing operational processes to identify areas for improvement and enhance productivity
• Developing strategies to optimize operational efficiency and drive business performance
• Collaborating with clients to implement technology solutions and process automation
• Supporting the development of operational excellence frameworks to improve quality and efficiency
• Gathering and interpreting data to inform operational strategies and solutions
• Applying lean process improvement techniques to streamline operations
• Engaging in project management tasks to support operational initiatives
• Utilizing emerging technologies to enhance operational processes and solutions
• Contributing to the development of innovative solutions for client challenges
• Participating in team discussions to provide insights and recommendations for operational improvements
  
  

• At least a Bachelor's degree
• At least 1 to 4 years of experience
• Oral and written proficiency in English required
• Proven experience in coding denials/quality assurance/training
• Strong knowledge of medical billing processes and insurance reimbursement
• Experience with healthcare billing software and Microsoft Office applications
  
  

• Utilizing automation solutions for operational excellence
• Implementing business process improvements for cost efficiency
• Excelling in operational analysis and strategy development
• Applying lean process improvement methodologies
• Demonstrating skills in process mapping and optimization
• Engaging in technology implementation for enhanced service operations
• Adapting to emerging technologies in a fast-paced environment
• Demonstrating knowledge of insurance and payer relations
• Identifying opportunities for process improvement
• Epic HB & PB experience is mandatory