Denials Management Lead — Revenue Recovery Champion

Health Business Solutions LLC; Pasig; Sur place; PHP 500 000 - 750 000; Plein temps

Résumé du poste

Health Business Solutions LLC is seeking a Denial Management Team Lead to guide a claims denial team. You will coach specialists, review denials, and coordinate appeals, with emphasis on quality, productivity, and timely filing.

The role requires collaboration with coding, billing, clinical, payer, and client teams to maximize reimbursement. You will monitor backlogs and performance, implement corrective actions, and ensure adherence to regulatory requirements while driving continuous process

Qualifications

• Minimum 2 years in healthcare revenue cycle management specifically denial management.
• At least 1 year in a team lead or senior specialist role within healthcare revenue cycle.
• Ability to use data and metrics to drive coaching and improvement.
• Strong communication with stakeholders and payer policies.
• Experience with denials, appeals, and clinical documentation.

Responsabilités

• Lead and develop Denials Specialists to meet targets.
• Review and prioritize denied claims and file accurate appeals.
• Serve as escalation point for complex denials and payer disputes.
• Analyze denial trends and coordinate corrective actions with teams.
• Monitor performance, backlogs, and quality results; provide coaching.
• Ensure compliance with regulatory and client requirements.

Connaissances

Leadership

Coaching

Communication

Analytical thinking

Problem solving

Stakeholder management

Conflict resolution

Prioritization

Escalation handling

Team development

Formation

Bachelor’s degree or equivalent

CPB or CRCR certification (plus)

Outils

EHR systems

Billing systems

Payer portals

Revenue cycle software

Description du poste

Health Business Solutions LLC is seeking a Denial Management Team Lead to guide a claims denial team. You will coach specialists, review denials, and coordinate appeals, with emphasis on quality, productivity, and timely filing.

The role requires collaboration with coding, billing, clinical, payer, and client teams to maximize reimbursement. You will monitor backlogs and performance, implement corrective actions, and ensure adherence to regulatory requirements while driving continuous process