Denials and Appeals Supervisors/TL
Save this job and keep your search organized
Create a free account to save jobs, create alerts and return to this listing from your dashboard.
By continuing, you agree to our Terms & Privacy Policy.
About the role
This role provides day-to-day oversight of Denials and Appeals Specialists supporting clinic, surgical, ancillary, and Workers' Compensation services.
Key responsibilities
Provide day-to-day operational oversight, direction, and support to Denials and Appeals Specialists responsible for clinic, surgical, ancillary, and Workers’ Compensation claim edits, denials, corrected claims, reconsiderations, appeals, and payer follow-up.
Serve as the technical resource for complex or high-value denials, payer disputes, reimbursement issues, and escalations.
Monitor denial trends, root causes, payer issues, aging accounts, and financial impact to identify opportunities to reduce preventable revenue loss.
Analyze denial performance using data warehouse and reporting tools, and provide regular reports and recommendations to Revenue Cycle leadership.
Monitor team productivity, quality, work queues, account aging, follow-up timeliness, and appeal deadlines.
Conduct quality reviews and provide coaching, training, and technical guidance to improve accuracy, productivity, and compliance.
Research complex denials and determine appropriate resolution, including corrected claims, reconsiderations, appeals, disputes, and payer escalations.
Collaborate with Coding, Authorization, Credentialing, Managed Care, Clinical, Revenue Cycle, and Operations teams to resolve issues affecting claims and reimbursement.
About you
Bachelor's degree graduate
At least 5 years of progressive healthcare revenue cycle experience, including direct experience in denial management, insurance accounts receivable, payer follow-up, corrected claims, reconsiderations, and appeals.
At least 2 years in leadership role
Advanced experience researching and resolving complex payer denials and reimbursement issues across multiple payer types and service lines.
Demonstrated experience providing day-to-day leadership, technical guidance, training, mentoring, or operational support to Revenue Cycle team members.
Experience utilizing reporting platforms or business intelligence tools to monitor Revenue Cycle performance, analyze trends, and communicate findings.
Experience utilizing an Electronic Medical Record (EMR)
Willing to work onsite (Bridgetowne, Quezon City) and night shift schedule
-
Training Quality Manager
2 days ago
quezon city, metro manila, Philippines Recruitify_HR Full-time ₱613,800 ContractDescription The Training Quality Manager is responsible for overseeing the quality of training programs and ensuring compliance with healthcare standards. Manage utilization management and medical necessity approval and denials. Handle a team of leaders, TLs, and Supervisors. Conduct training and quality management activities. Analyze complex medical...
-
Training Quality Manager
5 days ago
Quezon City, Metro Manila, Philippines Gratitude Philippines Full-time ₱446,400 - ₱669,600 ContractDescription The Training Quality Manager is responsible for overseeing the quality of training programs and ensuring compliance with healthcare standards. Manage utilization management and medical necessity approval and denials. Handle a team of leaders, TLs, and Supervisors. Conduct training and quality management activities. Analyze complex medical...
-
Quezon City, Metro Manila, Philippines Vector Outsourcing Solutions Phils. Remote Full-time ₱335,000 - ₱446,000 ContractSalary: 30,000 PHP - 40,000 PHPJob Description:Learn new systems of clients and effectively transfer knowledge to subordinates.Lead designated team, ensuring accurate and timely submission of deliverables.Coach subordinates and develop their skills.Assist Supervisor/Assistant Manager/Manager in directing the team towards the company's goals.Ensures...
-
Officer, Risk Operations
1 day ago
Quezon City, Metro Manila, Philippines JG Summit Holdings, Inc. Full-time ₱1 - ₱2 Contract8F Tera Tower, Quezon City, National Capital Region, Philippines1 - 3 YearsJob DescriptionRisk Operations OfficerGrow Beyond UR Job with URC! Create UR journey in a workplace where your growth goes beyond UR job. Thrive in an environment filled with fun, collaboration, and fulfillment as we delight everyone with good food choices.Universal Robina Corporation...
-
Insurance Benefit Coordinator
5 days ago
Quezon City, Metro Manila, Philippines Intelassist Inc. Full-time ₱240,000 - ₱360,000 ContractJob Description:The Insurance Benefit Coordinator functions as an integral member of a multidisciplinary intake team which manages the care of new patients. This position will verify a patient’s health benefits and coverage for infusion services. The Insurance Benefit Coordinator works closely with the Intake team to process new referrals timely. Ensures...
-
Mandaluyong City, Philippines Vector Outsourcing Solutions Phils. Remote Full-time ₱30,000 - ₱40,000 ContractSalary: 30,000 PHP - 40,000 PHP Job Description: Learn new systems of clients and effectively transfer knowledge to subordinates.Lead designated team, ensuring accurate and timely submission of deliverables.Coach subordinates and develop their skills.Assist Supervisor/Assistant Manager/Manager in directing the team towards the company's goals.Ensures...
-
Training Quality Manager
4 days ago
Quezon City, Metro Manila, Philippines Recruitify_HR Full-time ₱424,080 - ₱613,800 ContractDescription The Training Quality Manager is responsible for overseeing the quality of training programs and ensuring compliance with healthcare standards. Manage utilization management and medical necessity approval and denials. Handle a team of leaders, TLs, and Supervisors. Conduct training and quality management activities. Analyze complex medical...
-
Quality Analyst
3 hours ago
Muntinlupa City, Metro Manila, Philippines Gear Full-timeQuality Assurance & Performance Monitoring Audit a daily sample of billers' case transcripts.Document audit results in a standardized tracker and ensure Completeness and consistency of findings. Identify patterns and recurring errors from audit results and escalate major discrepancies or compliance risks to Team Leads or Ops Managers.Collaborate with TLs...
-
Medical Billing Specialist
3 hours ago
Eastwood Quezon City, Philippines Sourcefit Remote Full-timePosition Summary:We are currently seeking a detail-oriented, energetic, and focused Medical Biller, specializing in AR & Charge Entry. The ideal candidate is a high achiever committed to their career and demonstrates exceptional capability and commitment in handling complex billing tasks in a high-volume, fast-paced work environment. About the Client: Our...
-
Cebu City, Central Visayas, Philippines Vector Outsourcing Solutions Phils. Remote Full-time ₱335,000 - ₱446,000 ContractSalary: 30,000 PHP - 40,000 PHPJob Description:Learn new systems of clients and effectively transfer knowledge to subordinates.Lead designated team, ensuring accurate and timely submission of deliverables.Coach subordinates and develop their skills.Assist Supervisor/Assistant Manager/Manager in directing the team towards the company's goals.Ensures...
