Remote Denials & Appeals Specialist — Revenue Recovery Pro

Private Advertiser; Taguig; Hybrid; PHP 558,000 - 837,000; Full time

Benefits offered by this job

Work From Home

Dayshift

Job summary

Private Advertiser is seeking a Denials & Appeals Specialist to join our Post-Service Denials team. You will own the denial, research root causes, and drive corrective actions to recover revenue for clinic and surgical services.

The role requires 3+ years of Healthcare RCM experience, experience investigating denials, and preparing appeals. This is a remote, dayshift opportunity with a salary range of Php 50,000–Php 75,000 monthly.

Qualifications

• 3+ years of experience in Healthcare RCM, medical billing, insurance follow-up, AR, denial management, or a related healthcare function.
• Hands-on experience researching and resolving insurance denials.
• Experience with corrected claims, reconsiderations, written appeals, and payer follow-ups.
• Good understanding of claim processing, payer adjudication, denial reasons, and healthcare reimbursement.
• Experience using EMR, practice management, patient accounting, or similar healthcare systems.

Responsibilities

• Review and investigate insurance/payer denials for clinic and surgical services.
• Analyze claim history, denial reasons, payer responses, documentation, and account information.
• Determine the appropriate resolution and prepare corrected claims, reconsiderations, and written appeals.
• Conduct payer follow-ups and track accounts through final resolution.
• Review payer policies, reimbursement guidelines, medical policies, and contractual requirements.
• Work closely with Coding and Revenue Cycle teams to resolve issues involving coding, modifiers, bundling, medical necessity, documentation, authorization, eligibility, and other denial drivers.
• Identify payer processing errors and pursue corrections, appeals, or escalations.
• Maintain accurate documentation of research, payer communications, actions taken, and outcomes.
• Manage assigned work queues and ensure follow-ups are completed within payer filing and appeal deadlines.
• Identify recurring denial trends and provide insights that can help prevent future denials and reduce revenue loss.

Skills

Healthcare RCM

Denials & Appeals

Claim investigation

Payer follow-ups

Job description

Private Advertiser is seeking a Denials & Appeals Specialist to join our Post-Service Denials team. You will own the denial, research root causes, and drive corrective actions to recover revenue for clinic and surgical services.

The role requires 3+ years of Healthcare RCM experience, experience investigating denials, and preparing appeals. This is a remote, dayshift opportunity with a salary range of Php 50,000–Php 75,000 monthly.