RCM Denials & Appeals Team Lead (Night Shift, Onsite)

John Clements Consultants, Inc.; Quezon City; On-site; PHP 600,000 - 900,000; Full time

Job summary

John Clements Consultants, Inc. seeks a Post-Service Denials and Appeals Lead to oversee a team of Denials and Appeals Specialists across clinic, surgical, ancillary, and Workers' Compensation services.

You will monitor performance, trends, and workflows while guiding staff to ensure timely reimbursement and minimize revenue loss. You will provide coaching, analyze denial data using the data warehouse and reporting tools, and coordinate daily workload to meet departmental targets while working

Qualifications

• Minimum five (5) years of progressive healthcare revenue cycle experience, including denial management and appeals.
• Advanced experience researching and resolving complex payer denials across multiple payer types.
• Experience leading Revenue Cycle teams with coaching and accountability.
• Experience using reporting platforms to monitor performance and trends.
• Strong analytical and communication skills.
• Willing to work Night Shift and 100% onsite.

Responsibilities

• Provide day-to-day operational oversight and support to Denials and Appeals Specialists for clinic, surgical, ancillary, and Workers' Compensation claims.
• Serve as primary technical and operational resource for Specialists on complex denials and payer disputes.
• Monitor denial activity to identify trends and opportunities to prevent recurrent denials.
• Utilize data warehouse and reporting platforms to monitor denial volumes, aging, trends, and financial impact.
• Develop and communicate routine denial reporting and trend analysis to leadership.

Skills

Denial management

Payer follow-up

Leadership

Data analysis

Revenue cycle

Tools

EMR system

Practice management

BI tools

Job description

John Clements Consultants, Inc. seeks a Post-Service Denials and Appeals Lead to oversee a team of Denials and Appeals Specialists across clinic, surgical, ancillary, and Workers' Compensation services.

You will monitor performance, trends, and workflows while guiding staff to ensure timely reimbursement and minimize revenue loss. You will provide coaching, analyze denial data using the data warehouse and reporting tools, and coordinate daily workload to meet departmental targets while working