Remote Claims Appeal

unifyCX is seeking a detail-oriented Healthcare Billing and AR Follow-up Representative to support accurate billing and accounts receivable operations. You will manage claim processing, denial resolution, and payer follow-up to ensure timely payments while maintaining compliance with payer requirements.Responsibilities include preparing claims...

Concentrix Philippines is seeking a Clinical Appeals Specialist (PHRN) to review, process, and resolve appeals in line with NCQA and CMS standards. You will ensure timely, clinically sound determinations and support case documentation for payor programs.The role requires a BS Nursing with an active PHRN license, 1 year with InterQual or MCG, and 2 years...

MicroSourcing International is seeking a Claims Associate to support customers filing insurance claims from a remote setting in Metro Manila. The role requires handling incoming claims, gathering necessary information, and helping claimants understand policies to ensure fair processing. You will follow up on claims, resolve customer concerns, and provide...

Private Advertiser is seeking a Clinical Appeals Specialist for a temporary work-from-home role. You will handle client inquiries, provide assistance, and help resolve issues efficiently to maintain high service levels.The role requires 1+ year BPO/CPO experience, familiarity with InterQual or MCG, and 2+ years bedside clinical experience (ICU/CCU/ER). PHRN...

Vector Outsourcing Solutions Phils. is seeking a Dental Billing Specialist to join the Dental Insurance Billing/Collections Team. You will handle billing, collections, and payments posting for U.S.clinics. Responsibilities include creating accurate claims for maximum reimbursement, tracking claim status, and coordinating with clinics to gather supporting...

MicroSourcing is hiring a Customer Specialist in Metro Manila with a remote, day-shift setup. You will own the customer experience, manage tickets and claims via our XClaim platform, and collaborate with Support and Claims teams to meet SLAs and NPS targets.Strong attention to detail and English fluency are essential to review cases, communicate updates, and...

John Clements Consultants, Inc. is recruiting a Quality Analyst for a leading US healthcare organization. You will audit completed member appeal cases to ensure accuracy, timeliness, and regulatory compliance.In this role, you will verify case documentation against CMS, HIPAA, and client requirements, monitor processing timelines, and identify opportunities...

Ready Roles is seeking a Remote Customer Service Representative to be the frontline contact for a U.S.-based company, resolving issues and maintaining customer satisfaction.The role emphasizes billing and claims handling, requires empathy, patience, and tech-savviness, and suits a people-centered professional.Experience with CRM tools and strong English...

Outsource Access, Inc. is seeking a detail-oriented claims invoicing specialist for a remote role.You will write Xactimate invoices within 24 hours of job completion for water, mold, and fire restoration, and compile documentation to submit to insurance carriers within 48 hours. You will conduct disciplined follow-ups on a fixed bi-weekly schedule to secure...