NYS Workers’ Comp Appeals Specialist

Scriberunner Philippines Inc.; Biñan; On-site; PHP 725,000 - 1,060,000; Full time

Benefits offered by this job

HMO

Night differential

Performance incentives

Job summary

ScribeRunner Philippines Inc. is recruiting for a NYS workers’ compensation appeals specialist. You will manage denied and underpaid NYS claims end-to-end, formulating persuasive appeals grounded in NYS MTG, and applying prior authorization rules where needed.

Role requires strong written and spoken English, familiarity with WCB and payer portals, and a high-volume outreach approach to carriers and attorneys. Training will cover MTG navigation and NYS rules. Based in Laguna, Philippines.

Qualifications

• Minimum 2 years in US healthcare revenue cycle (denials, appeals, AR follow-up) or related US medical-legal billing experience.
• Ability to read a denial and craft a written argument for appeal.
• Excellent written English; appeals reviewed by carriers and Board.
• Confident spoken English and comfort with high-volume outbound calls to US carriers and attorneys.
• Proficiency with claims management systems and payer portals.
• HIPAA awareness is an advantage.

Responsibilities

• Handle NYS workers’ compensation denials from denial to resolution end-to-end.
• Read C-8.1 denials to identify the true reason for non-payment and path to overturn it.
• Draft MTG-based appeals with guideline citations.
• Apply NYS prior authorization rules as required.
• Read Notices of Decision and determine carrier vs provider stance.
• Use the WCB site to verify case status and body parts.
• Interpret carrier correspondence and reconcile with billing.
• Request Notices of Decision by email and track receipt.
• Maintain audit-ready documentation with HIPAA compliance.
• Report workload metrics: appeal volume, overturn rate, aging, patterns.
• Stay updated with NYS WCB rules and forms.

Skills

US workers’ compensation

Denial interpretation

Written English

Spoken English

Outreach calls

Research & analysis

Claims systems & portals

HIPAA awareness

Tools

MS Office / Google Workspace

Job description

ScribeRunner Philippines Inc. is recruiting for a NYS workers’ compensation appeals specialist. You will manage denied and underpaid NYS claims end-to-end, formulating persuasive appeals grounded in NYS MTG, and applying prior authorization rules where needed.

Role requires strong written and spoken English, familiarity with WCB and payer portals, and a high-volume outreach approach to carriers and attorneys. Training will cover MTG navigation and NYS rules. Based in Laguna, Philippines.