Denials & Appeals Specialist - Night Shift (RCM)

Our Clients; Quezon City; Vor Ort; PHP 300.000 - 600.000; Vollzeit

Zusammenfassung

Our Clients is seeking a Denial Management Specialist to join the Revenue Cycle Management team in Bridgetowne, Quezon City. The role focuses on reviewing, researching, and resolving post-service payer denials for clinic and surgical services.

You will investigate denial reasons, determine resolutions, and handle corrected claims, reconsiderations, and appeals, while collaborating with Coding and other teams to reduce revenue loss.

Qualifikationen

• 3+ years in healthcare Revenue Cycle Management or related function.
• Direct experience researching and resolving insurance denials.
• Experience handling corrected claims, reconsiderations, written appeals, and payer follow-ups.

Aufgaben

• Review, research, and resolve payer denials for clinic and surgical services.
• Analyze denial reasons, claim history, payer responses, and documentation to determine resolutions.
• Prepare and submit corrected claims, reconsiderations, written appeals, and supporting docs per payer requirements.

Kenntnisse

RCM experience

Denials management

Analytical skills

Attention to detail

Communication skills

Tools

EMR/Practice mgmt

athenaOne

EPICor

Jobbeschreibung

Our Clients is seeking a Denial Management Specialist to join the Revenue Cycle Management team in Bridgetowne, Quezon City. The role focuses on reviewing, researching, and resolving post-service payer denials for clinic and surgical services.

You will investigate denial reasons, determine resolutions, and handle corrected claims, reconsiderations, and appeals, while collaborating with Coding and other teams to reduce revenue loss.