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    • Review, analyze, and resolve denied medical claims.
    • Knowledge of medical billing, EOBs, ERA, and payer guidelines specifically BCBS.
    • View all Uplift Healthcare Solutions jobs - National Capital Region jobs - Accounts Receivable Clerk jobs in National Capital Region
    • Salary Search: Accounts Receivable (AR) Medical Denials Specialist salaries in National Capital Region
    • Interact with customers to gather support data to ensure invoice accuracy and also work through specific billing discrepancies.
    • Experience in medical billing/AR collections.
    • SHS Grad or completed at least 2 years of college.
    • Minimum 12 months experience in Healthcare Account Receivable/…
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Accounts Receivable (AR) Medical Denials Specialist
Uplift Healthcare Solutions
National Capital Region
•
Remote
PHP 45,000 - PHP 50,000 a month
Full-time
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Job details

PHP 45,000 - PHP 50,000 a month
Full-time
Remote in National Capital Region

Full job description

We are seeking an experienced Accounts Receivable (AR) Denials Specialist to join our growing healthcare team. The ideal candidate will have strong experience in physician claims management, denial resolution, and insurance follow-up. This role is responsible for managing the complete denial lifecycle, ensuring timely resolution of denied claims to maximize reimbursement.

Key Responsibilities
- Manage and work assigned physician insurance claims.
- Review, analyze, and resolve denied medical claims.
- Perform timely follow-up with insurance payers regarding claim denials and underpayments.
- Investigate denial root causes and take appropriate corrective actions.
- Submit reconsiderations, corrected claims, and appeals when necessary.
- Manage the denial turnaround process to ensure prompt claim resolution.
- Document all claim activities accurately within the billing system.
- Monitor claim status until final payment or resolution.
- Work the complete denial lifecycle from initial follow-up through final resolution.
- Collaborate with internal teams to identify trends and recommend process improvements that reduce future denials.
- Meet daily productivity and quality expectations while maintaining compliance with payer guidelines.
- Review BCBS E&M coding-related claims and identify issues requiring dispute or appeal.

Qualifications
- Experience in using Availity and EPIC
- Minimum of 2 years of recent U.S. healthcare Accounts Receivable (AR) experience.
- Strong background in physician claims and denial management.
- Experience handling commercial and government insurance payers.
- Thorough understanding of the denial lifecycle, appeals, and insurance follow-up.
- Knowledge of medical billing, EOBs, ERA, and payer guidelines specifically BCBS
- Excellent analytical, problem-solving, and communication skills.
- Ability to work independently in a fast-paced environment while meeting productivity goals.

Pay: Php45,000.00 - Php50,000.00 per month

Application Question(s):

  • Do you have experience using Availity?
  • Do you have experience using EPIC?

Experience:

  • U.S. healthcare Accounts Receivable (AR): 2 years (Required)

Work Location: Remote

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