Denials Specialist

2 days ago

Philippines BizForce Full time $60,000 - $80,000 per year
Description

We are looking for a skilled Denials Specialist with a strong background in ENT/Allergy specialty billing and hands-on experience with Athena IDX. This role is ideal for someone who thrives in resolving claim denials, understands payer rules, and can proactively prevent revenue loss through accurate follow-ups and appeals.

Key Responsibilities:

  • Review and analyze denied or underpaid claims related to ENT/Allergy services.
  • Work within Athena IDX to manage claim rejections, denials, and appeals.
  • Identify root causes of denials and recommend process improvements.
  • Submit corrected claims, appeals, and additional documentation as required.
  • Collaborate with billing, coding, and clinical teams to ensure proper claim submission.
  • Stay updated on payer guidelines, policies, and regulatory compliance.
  • Track denial trends and prepare reports for management.
Requirements
  • Minimum of 3 years' experience as a Denials Specialist, Medical Biller, or related role.
  • Experience with ENT/Allergy specialty billing.
  • Proficiency in Athena IDX.
  • Strong knowledge of insurance guidelines, denial codes, and appeals processes.
  • Excellent problem-solving, communication, and follow-up skills.
  • Certification (CPC, CPB, or equivalent) preferred but not required.
  • Amenable to work during U.S. business working hours.
Benefits
  • Permanent Work From Home
  • Weekly Paychecks
  • Fixed Weekends Off
  • HMO Reimbursement on your 90th day
  • Thriving Company Culture with Complete Autonomy
  • Exclusive Specialized Training Programs
  • Unlock Your Potential with a Highly Competitive Salary

____________________________________________________________________

Who are we?

MedCore Solutions is the healthcare division of BizForce, dedicated to supporting U.S.-based healthcare clients through a skilled remote workforce in the Philippines. We specialize in connecting top clinical and administrative talent with reputable healthcare organizations, ensuring high-quality care delivery while providing rewarding work-from-home careers.

Why work for Bizforce?

Bizforce is a global remote workforce solutions company currently partnering with some of the largest Architectural and Engineering firms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today Bizforce was founded with one goal – to deliver dependable high-quality skilled labor and business processes to US-based companies at affordable prices. Bizforce has grown rapidly and allows the best talent in PH to work remotely from home with the latest technology and resources. BizForce is proud to partner with PH to deliver qualified, professional workers, giving our Architects and Engineers the ability to have an unbeatable career and work from home.

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