Workers' Compensation Specialist

ScribeRunner; Biñan; A distancia; PHP 1.588.000 - 2.541.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive salary

Statutory benefits

Training and growth opportunities

Descripción de la vacante

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.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

US healthcare RCM

Denials

Appeals

Outbound calls

English proficiency

Payer portals

Herramientas

MS Office

Google Workspace

Payer portals

Descripción del empleo

We're Hiring: Workers' Compensation Specialist (US – New York State) ScribeRunner Philippines Inc. is building a specialized US Workers' Compensation team, and we're looking for Specialists to help US healthcare providers recover payment for care already given to injured workers.

What you'll do

• Own denied and underpaid NYS workers' comp claims from denial through payment
• Review Form C-8.1 denials, EORs and carrier correspondence to find the real reason for non-payment
• Draft appeals that cite the NYS Medical Treatment Guidelines (MTG)
• Review and request Workers' Compensation Board (WCB) Notices of Decision and act on each ruling
• Apply NYS prior authorization rules and verify case status and body parts on the WCB website
• Make high-volume outbound calls to US carriers and claimant attorneys' offices, and follow up through payer portals
• Keep complete, audit-ready documentation and report on appeals, overturn rates, claim aging and denial trends

What we're looking for

• 2+ years in US healthcare RCM, specifically denials, appeals, AR follow-up or prior authorization (no-fault, personal injury or US medical-legal billing experience also counts)
• Ability to identify the root cause of a denial and write a clear argument against it
• Excellent written and confident spoken English
• Comfortable with high-volume outbound calls
• Strong research skills and attention to detail
• Experience with claims systems, payer portals, and MS Office or Google Workspace
• Able to manage a large caseload independently and prioritize by deadline and value
• Sound judgment with confidential medical information; HIPAA awareness is a plus
• Willing to work US business hours

Nice to have

• NYS workers' compensation experience on the provider or billing side
• Working knowledge of the NYS Medical Treatment Guidelines
• Experience with C-8.1 denials, Notices of Decision, EORs and WCB case lookups

No NYS workers' comp experience? You can still apply.

If you have strong US denials and appeals experience, we'll train you through a structured NYS program covering MTG navigation, authorization rules, C-8.1 interpretation, Notices of Decision and WCB case lookup. Just mention this clearly in your application.

What we offer

• Competitive salary and full statutory benefits
• Night differential and performance incentives
• Specialized, highly marketable NYS workers' comp training
• Clear growth path to Senior Specialist, QA and Team Lead roles
• A chance to help build a brand-new team, with direct access to leadership