Denials Management Specialist (Revenue Cycle)

Health Business Solutions; Pasig; Vor Ort; PHP 350.000 - 520.000; Vollzeit

Zusammenfassung

Health Business Solutions is seeking a Revenue Cycle Denials Specialist in the Philippines. You will analyze denied or underpaid claims, research payer policies, and draft appeals to maximize reimbursement while ensuring compliance with regulations.

You will work with EHR and billing systems, common denial patterns, and use payer portals to track resolutions. A Bachelor’s degree and 2+ years in denial management are preferred.

Qualifikationen

• 2+ years of experience in healthcare revenue cycle management, specifically denial management.
• Familiarity with ICD-10-CM, CPT, HCPCS and medical necessity guidelines.
• Experience with EHR and billing systems.
• CPB, CRCR or similar certification is a plus.

Aufgaben

• Review denied, rejected, and underpaid claims to determine root causes.
• Research payer policies and guidelines to support appeals and resolutions.
• Prioritize denial inventory based on financial impact and filing deadlines.
• Draft and submit first- and second-level appeals with supporting documentation.
• Follow up with payers to ensure timely review and adjudication of appeals.
• Maximize reimbursement through corrections and reconsideration requests.
• Monitor aging denial accounts and track recovery of revenue.

Kenntnisse

Denial management

EHR systems

Microsoft Excel

Coding guidelines

Payer portals

Revenue cycle software

Appeal writing

Ausbildung

Bachelor’s degree

Tools

Denial management software

Payer portals

Jobbeschreibung

Health Business Solutions is seeking a Revenue Cycle Denials Specialist in the Philippines. You will analyze denied or underpaid claims, research payer policies, and draft appeals to maximize reimbursement while ensuring compliance with regulations.

You will work with EHR and billing systems, common denial patterns, and use payer portals to track resolutions. A Bachelor’s degree and 2+ years in denial management are preferred.