Clinical Denials & Appeals Specialist - Night Shift

TASQ Staffing Solutions; Quezon City; On-site; PHP 446,000 - 781,000; Full time

Job summary

TASQ Staffing Solutions seeks a Clinical Reviewer Specialist to maximize healthcare reimbursement by reviewing denied claims, identifying root causes, and developing persuasive appeal strategies. You will analyze medical records, coding data, payer policies, and documentation to determine denial validity and reimbursement opportunities.

This is an onsite role with a focus on quality and impact. The candidate should have active coding certifications, IP DRG / HCC experience, 3+ years in revenue

Qualifications

• Active coding certifications required.
• Minimum 3 years in healthcare revenue cycle, medical billing, claims processing, or denial management.
• IP DRG Coding, Inpatient Surgery Coding, Inpatient E&M / Professional Coding, Inpatient HCC / Risk Adjustment Coding.

Responsibilities

• Review denied claims to identify denial reasons, discrepancies, and opportunities for appeal.
• Analyze medical records, coding, payer policies and documentation to validate denials.
• Develop clear, persuasive appeal arguments supported by clinical evidence and coding guidelines.
• Collaborate with providers and revenue cycle teams to obtain supporting docs and address recurring denial patterns.

Skills

Coding certifications

PHRN

USRN (plus)

ICD-10-CM/PCS

Denials & Appeals

Medical billing

Revenue cycle

Education

CDAS or equivalent denial management credential

Job description

TASQ Staffing Solutions seeks a Clinical Reviewer Specialist to maximize healthcare reimbursement by reviewing denied claims, identifying root causes, and developing persuasive appeal strategies. You will analyze medical records, coding data, payer policies, and documentation to determine denial validity and reimbursement opportunities.

This is an onsite role with a focus on quality and impact. The candidate should have active coding certifications, IP DRG / HCC experience, 3+ years in revenue