Denial Management Executive (Ortigas, Alabang, Clark) (Medical Coder)

Ingenious Solutions Inc.; Pasig; On-site; PHP 334,800 - 558,000; Full time

Job summary

A healthcare solutions provider is seeking a skilled Medical Coder to join the Denials Management team. This role requires an active AAPC or AHIMA License, expertise in OP coding and claims denial management, and the ability to work onsite during night shifts. Candidates will be responsible for researching payer denials, writing appeals, and identifying patterns to improve efficiency. This position offers opportunities for professional development in a dynamic healthcare environment.

Qualifications

• Active AAPC or AHIMA License required.
• Experience in OP coding and denial management necessary.
• Willingness to work onsite during night shifts.

Responsibilities

• Research and analyze payer denials for various reasons.
• Write professional appeal letters independently.
• Submit detailed appeals based on medical record reviews.
• Manage retro-authorizations in response to denials.
• Identify denial patterns and report to management.
• Recommend improvements to claim processes.

Skills

AAPC or AHIMA License

OP coding

Claims Denial Management

Profee coding

Job description

Ingenious Philippines is hiring! We are looking forMedical Codersto be part of our Denials Management team inAlabang, Ortigas and Clark!

Qualification:

• Must have have an active AAPC or AHIMA License
• Experience in OP coding, Claims, Denial Management
• Profee coding experience
• Amenable to onsite work and night shift

Responsibilities:

• • Research payer denials related to referral, pre-authorization, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.
• • Independently write professional appeal letters.
• • Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines as well as UW Health policies and procedures.
• • Submit retro-authorizations in accordance with payor requirements in response to authorization denials.
• • Identify denial patterns and elevate to management as appropriate with sufficient information foradditional follow-up, and/or root cause resolution.
• • Make recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency and reduce denials.