Workers Compensation Specialist

We're Hiring: Workers Compensation Specialist (US – New York State) ScribeRunner Philippines Inc. is building a specialized US Workers Compensation team, and we're looking for Specialists to help US healthcare providers recover payment for care already given to injured workers.

Biñan, Laguna, Philippines | Onsite

Full-time | US business hours (night shift)

What you'll do:

• Own denied and underpaid NYS workers comp claims from denial through payment

• Review Form C-8.1 denials, EORs and carrier correspondence to find the real reason for non-payment

• Draft appeals that cite the NYS Medical Treatment Guidelines (MTG)

• Review and request Workers Compensation Board (WCB) Notices of Decision and act on each ruling

• Apply NYS prior authorization rules and verify case status and body parts on the WCB website

• Make high-volume outbound calls to US carriers and claimant attorneys offices, and follow up through payer portals

• Keep complete, audit-ready documentation and report on appeals, overturn rates, claim aging and denial trends

What we're looking for

• 2+ years in US healthcare RCM, specifically denials, appeals, AR follow-up or prior authorization (no-fault, personal injury or US medical-legal billing experience also counts)

• Ability to identify the root cause of a denial and write a clear argument against it

• Excellent written and confident spoken English

• Comfortable with high-volume outbound calls

• Strong research skills and attention to detail

• Experience with claims systems, payer portals, and MS Office or Google Workspace

• Able to manage a large caseload independently and prioritize by deadline and value

• Sound judgment with confidential medical information; HIPAA awareness is a plus

• Willing to work US business hours

Nice to have

• NYS workers compensation experience on the provider or billing side

• Working knowledge of the NYS Medical Treatment Guidelines

• Experience with C-8.1 denials, Notices of Decision, EORs and WCB case lookups

No NYS workers comp experience You can still apply.

If you have strong US denials and appeals experience, we'll train you through a structured NYS program covering MTG navigation, authorization rules, C-8.1 interpretation, Notices of Decision and WCB case lookup. Just mention this clearly in your application.

What we offer

• Competitive salary and full statutory benefits

• HMO coverage

• Night differential and performance incentives

• Specialized, highly marketable NYS workers comp training

• Clear growth path to Senior Specialist, QA and Team Lead roles

• A chance to help build a brand-new team, with direct access to leadership