Denials And Appeals Education Specialist

Discover your 100% YOU with MicroSourcing!

Position: Denials & Appeals Education Specialist

Location: Taguig

Work setup & shift: Onsite | Night shift

Why join MicroSourcing?

Youll Have

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one (for you and at least one dependent), paid time-off with cash conversion, group life insurance, and performance bonuses.
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
  
  

Your Role

As a Denials & Appeals Education Specialist, You Will

• Deliver end-to-end process training covering assigned domains within Clinical Denials & Appeals.
• Facilitate induction training for new hires, cross-training for lateral moves, and refresher sessions for existing staff.
• Customize training modules based on client SLAs, payer guidelines (Medicare, Medicaid, Commercial), and EMR platforms (Epic, Cerner, Meditech).
• Conduct assessments, quizzes, and feedback sessions to evaluate training effectiveness and identify learning gaps.
• Collaborate with Clinical SMEs and Operations to ensure training content aligns with performance expectations and compliance standards.
• Prepare and maintain training materials, SOPs, and documentation aligned with client and audit requirements.
• Maintain training MIS, including batch performance, attendance, feedback, and certification data.
• Calibrate with QA teams to align training objectives with production quality and accuracy goals.
• Track post-training performance metrics such as speed-to-proficiency and productivity uplift.
• Participate in client calibration calls, internal audits, and process reviews to share training outcomes and performance insights.
  
  

What You Need

Non-negotiables

• At least 1 year of experience conducting classroom or virtual training for clinical appeals writing within a BPO or healthcare setting.
• 3-5 years of acute care clinical experience in a hospital setting (Med/Surg or similar preferred); 2-3 years if ICU experience.
• Bachelor of Science in Nursing.
• Registered Nurse (PHRN or USRN) with active license.
• Proficiency with InterQual or MCG clinical guidelines.
• Broad knowledge of U.S. Government Programs and Insurance Regulations.
• Experience with electronic medical records (EMR) such as Epic, Cerner, or Meditech.
  
  

Preferred skills/expertise

• Masters degree or credential in business, healthcare, or related field.
• Certification in case management, clinical appeals, or clinical denials.
• Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, SharePoint).
• Experience using software for tracking denials and appeals.
• Strong facilitation, communication, and presentation skills with the ability to simplify complex concepts.
• Excellent attention to detail, analytical thinking, and decision-making abilities.
• Demonstrated ability to work independently and collaboratively within a matrixed environment.
• High level of professionalism, integrity, and adaptability to changing client needs.
  
  

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our companys strength lies in our peoples diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan - its our commitment. Our way of life. Here, we dont just accept your unique authentic self - we celebrate it, valuing every individuals contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

Terms & conditions apply.

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