BPO - Denials and Appeals Specialist - US Healthcare (Hybrid Setup)

You know that moment when a problem finally starts to make sense—the reason clicks, the next step becomes clear, and you know exactly what to do. That’s your patience, attention to detail, and critical thinking at work—and it’s exactly what this role calls for.

Unity Communications is looking for a Denials and Appeals Specialist for our Healthcare Legal Solutions account. You’ll handle appeal follow-ups for hospital-based claims, connect with insurance providers, and track each case from status checks to final outcomes. You’ll verify details, document everything accurately, and make sure deadlines are met—especially when timing matters most. If you enjoy turning unclear cases into clear next steps, you’ll feel right at home here.

How You Spend Your Eight Hours

• Perform structured appeal follow-ups and denial intelligence gathering for hospital-based claims

• Conduct outbound calls to check appeal status using HLS-provided spreadsheets

• Verify the appeal receipt and identify the current stage of review

• Determine appeal outcomes (approved, denied, or pending)

• Validate full payment details, including amount, check/EFT number, issue date, and short payments for approved appeals

• Gather complete denial reasons and request a re-fax or resend of denial letters for denied appeals

• Confirm next-level appeal rights, correct filing address, and submission method

• Verify filing deadlines, including whether they follow calendar or business days

• Document representative names, reference numbers, and detailed call notes accurately

• Flag cases with filing deadlines within 10 days and identify appeals beyond regulatory review timeframes

What You Must Possess

• At least 2–3 years of experience in healthcare accounts, preferably in claims, billing, or appeals

• Familiarity with healthcare claims processes, denials, and appeals workflows

• Strong attention to detail and ability to handle time-sensitive cases

• Excellent communication skills for outbound calls and documentation

• Ability to follow structured processes and maintain accuracy in repetitive tasks

• Strong organizational and time management skills

• Basic proficiency in spreadsheets and documentation tools

• Ability to work independently and as part of a team

What You Shall Receive

• HMO coverage upon regularization, with one free dependent after one year of continuous service and another free dependent after two years of continuous service

• VL/SL credits upon regularization

• Friendly and supportive work culture

• 13th-month pay and other Philippine government-mandated benefits

• Non-taxable allowances

• Pay increases, performance bonuses, growth opportunities, birthday gifts, and many more

What You Should Consider

• Probationary, full-time position

• Hybrid work setup

Why Join Our Company

You look for a company whose senior management listens to what you are and aren’t saying and whose managers and team leads you can genuinely connect with. According to Glassdoor, 99% of the current and previous employees recommend Unity Communications to their friends, and 100% approve of its executive management. Our company is a Certified Great Place To Work that values inclusion and diversity and spreads kindness and positivity.