Billing Denials Management Specialist

RMLPH

Billing Denials Management Specialist investigating and resolving healthcare insurance claim denials. Collaborating with clinical staff and coding team to maximize reimbursement and maintain financial health.

Posted 7/29/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 ₱35,000 - ₱40,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical billing and denials management, with a strong focus on analyzing denial trends, preparing appeals, and collaborating with clinical staff. Maintains knowledge of payer policies and healthcare compliance standards to effectively resolve claim denials.

Highest-signal resume keywords

Denials ManagementClaims AppealsRevenue Cycle ManagementHIPAA ComplianceFinancial Impact Analysis

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medical BillingClaims RecoveryDenial Trend AnalysisStandard Operating Procedures DevelopmentDocumentation Preparation

Soft Skills

CollaborationProblem-SolvingAttention to Detail

Certifications & Qualifications

Associate's DegreeRelevant Certification

Industry Keywords

Payer PoliciesBilling RegulationsFalse Claims ActHealthcare Compliance StandardsOutpatient Setting

About the role

Key responsibilities & impact

Investigate and resolve all assigned insurance claim denials in a timely and efficient manner.
Analyze denial trends to identify root causes and patterns by payer, provider, or service type.
Develop, document, and implement standard operating procedures for resolving common denial reasons.
Prepare and submit compelling appeals to insurance companies with all necessary documentation.
Collaborate with the coding team and clinical staff to obtain corrected information or documentation for claim resubmission.
Track and report on denial statuses, recovery rates, and the financial impact of denial trends.
Maintain up-to-date knowledge of payer policies, billing regulations, and industry standards related to medical billing and denials.
Perform other duties as assigned related to revenue cycle management.

Requirements

What you’ll need

Minimum of 3 years of experience in a medical billing role with a focus on denials management, appeals, and collections.
High school diploma or equivalent required; Associate's degree or relevant certification is a plus.
Proven track record of successfully appealing and recovering denied claims.
Experience in a laboratory or similar outpatient setting is highly preferred.
Familiarity with HIPAA regulations, the False Claims Act, and other healthcare compliance standards.

Benefits

Comp & perks

Paid leave: Sick, Annual, Public holidays
New Hires begin as independent contractors for the first 6 months before they are eligible for a review for full-time employment