Billing Denials Management Specialist

Remote

Full Time

Experienced

Billing Denials Management Specialist

Location: Remote
Department: Billing
Reports To: Denial Billing Team Lad
Salary: 35,000 - 40,000 php

About Us:

RML-PH is a dynamic and innovative Health Solutions and Care Delivery Organization committed to transforming the healthcare landscape. With a mission to provide accessible, high-quality healthcare services and cutting-edge solutions, RML-PH focuses on holistic patient care and embraces the latest advancements in health technology. Our team is dedicated to providing top-tier customer care, leveraging expertise and technology to exceed expectations. Join us at RML-PH to be part of a dynamic team committed to delivering excellence in healthcare customer service.

Position Summary:

The Billing Denials Management Specialist plays a critical role in the revenue cycle by investigating, resolving, and preventing insurance claim denials. This position is responsible for analyzing rejected claims to identify root causes, developing and implementing corrective action plans, and creating sustainable processes to reduce future denials. The specialist will work closely with the billing team, coders, and payers to ensure that claims are processed accurately and efficiently, maximizing reimbursement and maintaining financial health.

Key Responsibilities:

Investigate and resolve all assigned insurance claim denials in a timely and efficient manner.
Analyze denial trends to identify root causes and patterns by payer, provider, or service type.
Develop, document, and implement standard operating procedures for resolving common denial reasons.
Prepare and submit compelling appeals to insurance companies with all necessary documentation.
Collaborate with the coding team and clinical staff to obtain corrected information or documentation for claim resubmission.
Track and report on denial statuses, recovery rates, and the financial impact of denial trends.
Maintain up-to-date knowledge of payer policies, billing regulations, and industry standards related to medical billing and denials.
Perform other duties as assigned related to revenue cycle management.

Qualifications:

Minimum of 3 years of experience in a medical billing role with a focus on denials management, appeals, and collections.
High school diploma or equivalent required; Associate's degree or relevant certification is a plus.
Proven track record of successfully appealing and recovering denied claims.
Experience in a laboratory or similar outpatient setting is highly preferred.
Familiarity with HIPAA regulations, the False Claims Act, and other healthcare compliance standards.

Benefits:

Paid leave: Sick, Annual, Public holidays.
New Hires begin as independent contractors for the first 6 months before they are eligible for a review for full-time employment.

Apply for this position

Required*

First Name*

Last Name*

Email Address*

Phone*

Address

Resume*

We've received your resume. Click here to update it.

Attach resume or Paste resume

Attach resume as .pdf, .doc, .docx, .odt, .txt, or .rtf (limit 5MB) or Paste resume

Paste your resume here or Attach resume file

Have you completed the following level of education: High School Diploma?*

Have you completed the following level of education: Bachelor's Degree?*

Are you willing to undergo a background check, in accordance with local law/regulations?*

Will you now or in the future require sponsorship for employment visa status?*

What is your level of proficiency in English?*

Are you open to the following work settings: (Select all that apply)* OnsiteHybridRemote

Do you have a minimum of 2 years of experience working with insurance denials?*

How many years of experience do you have in Insurance Denials?*

How many years of work experience do you have with Electronic Health Records (EHR)?*

How many years of work experience do you have with ICD-10?*

Is the posted pay range within your expectations?*

Do you have any relatives or referrals currently employed at RML-PH, or have you previously worked with us?*

Do you have experience working in a remote setting?*

Why would you be a good fit for this position?*

The following questions are entirely optional.

To comply with government Equal Employment Opportunity and/or Affirmative Action reporting regulations, we are requesting (but NOT requiring) that you enter this personal data. This information will not be used in connection with any employment decisions, and will be used solely as permitted by state and federal law. Your voluntary cooperation would be appreciated. Learn more.

Gender

Race/Ethnicity

Human Check*

Submit Application