Night-Shift Clinical Denials & Appeals Specialist

TASQ Staffing Solutions; Taguig; On-site; PHP 480,000 - 640,000; Full time

Job summary

TASQ Staffing Solutions is seeking a Clinical Reviewer Specialist for an onsite role in Taguig, Philippines. The position focuses on reviewing denied claims, analyzing medical records and payer documentation, and developing compelling appeals to improve reimbursement.

The candidate will work with healthcare providers and revenue cycle teams to address recurring denial patterns and support both recovery and denial prevention initiatives.

Qualifications

• Active coding certifications are required.
• Minimum 3 years of healthcare revenue cycle/claims experience.
• IP DRG Coding, Inpatient Surgery Coding, Inpatient E&M/Pro coding, Inpatient HCC/Risk Adjustment Coding experience preferred.

Responsibilities

• Review denied claims to identify denial reasons and opportunities for appeal.
• Analyze medical records, coding and billing data to validate denials.
• Develop persuasive appeals with clinical evidence and payer policies.
• Collaborate with providers and revenue cycle teams to obtain supporting documentation.

Skills

Denials analysis

Medical coding

Payer policies

Communication skills

ICD-10-CM/PCS

Tools

Epic EHR

Payer denial portals

Job description

TASQ Staffing Solutions is seeking a Clinical Reviewer Specialist for an onsite role in Taguig, Philippines. The position focuses on reviewing denied claims, analyzing medical records and payer documentation, and developing compelling appeals to improve reimbursement.

The candidate will work with healthcare providers and revenue cycle teams to address recurring denial patterns and support both recovery and denial prevention initiatives.