Night Shift Denials & Appeals Specialist

PM Consulting; Quezon City; On-site; PHP 391,000 - 614,000; Full time

Job summary

PM Consulting is seeking a Denials and Appeals Specialist to handle post-service payer denials for clinic and surgical services in Onsite Bridgetowne, Quezon City. You will research denials, prepare appeals, and coordinate with internal teams to drive resolution.

The role requires 3+ years in healthcare RCM, hands-on denial resolution experience, and familiarity with EMR and practice management systems. Night shift, onsite setting, in Corporate – Revenue Cycle Management.

Qualifications

• 3+ years of healthcare RCM experience, preferably in denial management, medical billing, insurance follow-up, or AR.
• Hands-on experience researching and resolving payer denials.
• Experience with corrected claims, reconsiderations, appeals, and payer follow-ups.
• Familiarity with EMR, practice management, and payer portals.

Responsibilities

• Review and research payer denials and determine the appropriate resolution.
• Prepare and submit corrected claims, reconsiderations, and written appeals with supporting documentation.
• Conduct payer follow-ups and monitor accounts through final resolution.
• Review claim history, payer policies, remittance information, and account documentation.
• Use payer portals, EMR/practice management systems, and other RCM tools to research and resolve denials.
• Coordinate with Coding and other Revenue Cycle teams for coding, authorization, eligibility, documentation, and other denial issues.
• Maintain accurate documentation and ensure timely action based on payer filing and appeal deadlines.
• Identify recurring denial trends and assist in denial prevention and process improvement.

Skills

RCM experience

Payer denials research

Claims corrections

Payer follow-ups

Tools

EMR

Practice Management System

Payer Portals

Job description

PM Consulting is seeking a Denials and Appeals Specialist to handle post-service payer denials for clinic and surgical services in Onsite Bridgetowne, Quezon City. You will research denials, prepare appeals, and coordinate with internal teams to drive resolution.

The role requires 3+ years in healthcare RCM, hands-on denial resolution experience, and familiarity with EMR and practice management systems. Night shift, onsite setting, in Corporate – Revenue Cycle Management.