AR Clinical Denials Director

6 days ago


Taguig, National Capital Region, Philippines ADI Group Full time ₱2,000,000 - ₱2,500,000 per year


Position Summary - 

Responsible for Client operations including the execution of Clinical Denials. Also has overall responsibility for delivering on respective process metrics such as account cycle time and functions thereof, process cost and functions thereof, adherence to process standards, and process quality. This involves conducting continuous quality monitoring of work product delivered and human resource direction and management.

Responsible for leading and managing staff and subordinate leadership. The position also involves achieving and sustaining excellent productivity and accuracy.

Essential Duties and Responsibilities - 

  1. Oversees overall functions, ensuring standardization and compliance with established policies and procedures of Revenue Cycle Solutions
  2. Manages all KPIs in collaboration with the OPs leaders and aspects of change management as it relates to operational processes, driving process metrics, staffing and employee relations, etc.
  3. Collaborates with all segments of leadership responsible for process design and development, process monitoring, and policy and procedure development.
  4. Directs the development of tactical plans and operating budgets to achieve strategic Conifer goals; monitor progress toward goals throughout the year.
  5. Hires, trains, and develops assigned Managers, Supervisors, Analysts and others. Partners with Human Resources to maintain consistent policy and manages expectations with recruiting department to ensure staffing levels are met.
  6. Provides operational direction to assigned site and business function. Coordinates site related issues with Human Resources and Legal.

Knowledge and abilities - 

  • Registered PH Nurse
  • With Healthcare and clinical BPO/shared experience
  • With 5-7 years of relevant experience
  • 7 - 10 years experience directing a multi-facility healthcare business office



  • Taguig, National Capital Region, Philippines JPRecruits Full time

    Key ResponsibilitiesDenial review: Analyze denial letters and medical records to determine the cause of rejection.Appeal preparation: Draft evidence-based appeals using clinical knowledge, guidelines (MCG/InterQual), and payer rules to justify medical necessity.Information collection: Coordinate with healthcare providers to secure required documentation for...

  • AR Director

    6 days ago


    Taguig, National Capital Region, Philippines PMConsulting Full time $80,000 - $160,000 per year

    Leads a large department of multiple teamsManages outstanding accounts receivable and monitors key performance indicators including but not limited to days in AR, aging, collection rates and denial resolution to ensure client service level agreements and organization performance metrics are consistently metEstablishes goals, expectations and clear...


  • Taguig, National Capital Region, Philippines MicroSourcing Full time ₱1,200,000 - ₱7,500,000 per year

    Discover your 100% YOU with MicroSourcingPosition:Clinical Revenue Operations DirectorLocation:TaguigWork setup & shift:Onsite | Night shiftWhy join MicroSourcing?You'll HaveCompetitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and...


  • Taguig, National Capital Region, Philippines HRTX Full time ₱1,500,000 - ₱3,000,000 per year

    Qualifications:Experience & EducationMinimum of 5+ years of combined experience in direct patient care and/or a clinical administrator role (e.g., utilization management, clinical authorizations, clinical denials, or clinical documentation integrity) with a solid track record in reputable organizations.Registered Nurse (RN) or hold another clinical patient...


  • Taguig, National Capital Region, Philippines ADI Recruitment, INC. Full time

    NOW HIRING: AR Collections Team LeadLocation: Taguig CityWe are looking for an experienced AR Collections Team Lead who can support our Healthcare Revenue Cycle operations and guide a high-performing team. If you have advanced knowledge in healthcare A/R and strong leadership capabilities, we want to hear from youKey Qualifications:2–3 years of experience...


  • Taguig, National Capital Region, Philippines Private Advertiser Full time $60,000 - $120,000 per year

    Job Opportunity: Registered Nurse Bedside experienceWe are seeking Registered Nurses to become part of our expanding team. In this role, you will help ensure the timely completion of patient cases by conducting roll calls, processing concurrent and retrospective clinical reviews, and handling surgery authorizations when required.Key ResponsibilitiesPerform...

  • Medical Biller

    6 days ago


    Taguig, National Capital Region, Philippines HRTX Full time $40,000 - $60,000 per year

    We are hiring for an experienced Medical Biller to join our growing U.S. healthcare team. In this role, you will manage the end-to-end Revenue Cycle Management process, ensuring timely and accurate claims submission, payment posting, AR follow-up, and denial management for our U.S. clients.This is a great opportunity for professionals with a solid background...


  • Taguig, National Capital Region, Philippines KMC Solutions Full time ₱1,200,000 - ₱2,400,000 per year

    Duties and responsibilitiesContact insurance carriers to verify patient's insurance eligibility, benefits and requirements.Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.Demonstrate and apply...


  • Taguig, National Capital Region, Philippines HRTX Full time $40,000 - $60,000 per year

    We are looking for an experienced Payment Posting Associate to join our growing U.S. healthcare team. In this role, you will manage the end-to-end Revenue Cycle Management process, ensuring timely and accurate claims submission, payment posting, AR follow-up, and denial management for our U.S. clients.This is a great opportunity for professionals with a...


  • Taguig, National Capital Region, Philippines HRTX Full time ₱30,000 - ₱60,000 per year

    We are looking for an experienced RCM Associate to join our growing U.S. healthcare team. In this role, you will manage the end-to-end Revenue Cycle Management process, ensuring timely and accurate claims submission, payment posting, AR follow-up, and denial management for our U.S. clients.This is a great opportunity for professionals with a solid background...