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Appeals Specialist

🏢
John Clements Consultants, Inc
📍 Pasig, Philippines
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Location Pasig
📅
Posted June 12, 2026
🚗
Commute Local Area
🎯
Local Opportunity Near You!

This job is in your area. Enjoy a short commute and work close to home.

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Job Description

The Appeals Specialist is responsible for managing payer denials and working with payers to resolve reimbursement errors. 

Responsibilities

  • Work with insurance companies to resubmit denied claims, over or underpaid claims, and claims that have processed inaccurately to secure payment on balances outstanding 
  • Work with payers to understand specific reasons for denials and measures to prevent future denials
  • Navigate through and review patient medical records
  • Research payer requirements and utilize clinical knowledge to determine whether an appeal is required
  • Maintain confidentiality of patient data and medical records in compliance with HIPAA regulations
  • Utilize various communication tools including IM and video conferencing to enable virtual work collaboration

    • Qualifications

  • Bachelor's degree in any field (Undergrads are welcome to apply)
  • At least 2+ years of...

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    📍 Location Details

    🌆
    City
    Pasig
    🗺️
    Country
    Philippines
    🚗
    Commute
    Local Area

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