Night-Shift Technical Denials Analyst (US Healthcare)

MicroSourcing; Philippines; On-site; PHP 391,000 - 614,000; Full time

Benefits offered by this job

Healthcare coverage on Day 1

Paid time off with cash conversion

Group life insurance

Performance bonuses

Job summary

MicroSourcing in the Philippines is hiring a Healthcare Denials Analyst (Technical) to manage and resolve non-clinical claim denials within the US healthcare revenue cycle. You will analyze denial root causes, correct claim issues, prepare technical appeals, and collaborate with payers and internal stakeholders to maximize reimbursement and reduce denials.

The role is onsite in BGC, Taguig with night shift; requires experience with CARC/RARC, ICD-10, CPT/HCPCS.

Qualifications

• Minimum of 1 year of experience in technical denials or US healthcare revenue cycle denial management.
• Senior High School Diploma or equivalent.
• Working knowledge of US healthcare revenue cycle management and medical billing processes.
• Experience with ICD-10, CPT/HCPCS, CMS-1500/UB-04 forms and CARC/RARC denial codes.
• Familiarity with InterQual/MCG guidelines and US government healthcare programs.
• Experience using hospital EMR systems (Epic/Cerner/Meditech).
• Excellent written and verbal English communication (CEFR B2).
• Strong analytical, problem-solving, organizational and time management skills.

Responsibilities

• Review denied claims using EOBs, ERAs, and payer portals to identify denial reasons and root causes.
• Interpret denial reason codes (CARC/RARC) and categorize denials (authorization, eligibility, coding, timely filing).
• Correct claim errors related to demographics, insurance, provider details, authorizations, and CPT/ICD coding validation.
• Prepare and submit non-clinical appeals with supporting docs (authorization, eligibility, timely filing).
• Monitor appeal status and perform timely follow-up to resolve claims.
• Manage denied/unpaid claims in A/R through payer follow-up via phone, email, portals.
• Collaborate with billing, coding, QA and other internal teams to resolve denial issues.
• Maintain documentation, denial tracking reports and support process improvements.

Skills

English communication (CEFR B2)

Analytical skills

Time management

Attention to detail

Problem solving

Organizational skills

Education

Senior High School Diploma or equivalent

Bachelor's degree in Healthcare Administration/Medical Technology/Pharmacy/Business/Finance/Accounting/Information Management or related field

Tools

Epic

Cerner

Meditech

Denial management systems

CARC/RARC denial codes

Job description

MicroSourcing in the Philippines is hiring a Healthcare Denials Analyst (Technical) to manage and resolve non-clinical claim denials within the US healthcare revenue cycle. You will analyze denial root causes, correct claim issues, prepare technical appeals, and collaborate with payers and internal stakeholders to maximize reimbursement and reduce denials.

The role is onsite in BGC, Taguig with night shift; requires experience with CARC/RARC, ICD-10, CPT/HCPCS.