NYS Workers' Comp Denials & Appeals Specialist

ScribeRunner; Biñan; Remote; PHP 1,588,000 - 2,541,000; Full time

Benefits offered by this job

Competitive salary

Statutory benefits

Training and growth opportunities

Job summary

ScribeRunner Philippines Inc. is building a specialized US Workers' Compensation team and seeks a specialist to help US healthcare providers recover payment for care already delivered to injured workers.

You will own NYS workers' comp claims from denial to payment, review denials, draft MTG-based appeals, work with WCB decisions, and perform high-volume outreach to carriers and attorney offices while maintaining audit-ready documentation.

Qualifications

• 2+ years in US healthcare RCM, denials, appeals, AR follow-up or prior authorization.
• Ability to identify root causes of denials and write a clear argument.
• Excellent written and spoken English.
• Comfortable with high-volume outbound calls.
• Strong research skills and meticulous attention to detail.
• Experience with claims systems, payer portals, and MS Office/Google Workspace.
• Able to manage a large caseload independently and prioritize by deadline.
• HIPAA awareness is a plus.
• Willing to work US business hours.

Responsibilities

• Own denied and underpaid NYS workers' comp claims from denial through payment.
• Review Form C-8.1 denials, EORs and carrier notes to find payment reasons.
• Draft appeals citing NYS MTG.
• Review and act on WCB Notices of Decision and rulings.
• Apply NYS prior authorization rules and verify status on WCB site.
• Make high-volume outbound calls to US carriers and claimant attorneys; follow up via payer portals.
• Maintain audit-ready documentation and report on appeals, overturn rates, and denial trends.

Skills

US healthcare RCM

Denials

Appeals

Outbound calls

English proficiency

Payer portals

Tools

MS Office

Google Workspace

Payer portals

Job description

ScribeRunner Philippines Inc. is building a specialized US Workers' Compensation team and seeks a specialist to help US healthcare providers recover payment for care already delivered to injured workers.

You will own NYS workers' comp claims from denial to payment, review denials, draft MTG-based appeals, work with WCB decisions, and perform high-volume outreach to carriers and attorney offices while maintaining audit-ready documentation.