# Team Leader - Clinical Denials

> Tasq Staffing Solutions, Inc. · Taguig, Philippines · Full-time · Posted 2026-09-10

**Workplace:** on_site

**Department:** Philippines - Corporate

## Description

**Work setup:** ONSITE / BGC, Taguig within 6 months then transfer to Bridgetowne, QC

**Work schedule:** Nightshift

The **Team Lead – Clinical Denials** provides operational and clinical leadership to a team of Clinical Denials Specialists supporting U.S. healthcare clients. The role oversees daily workflow, productivity, quality, employee performance, complex denial escalations, and denial prevention activities.

The Team Lead serves as a subject-matter resource for medical necessity, clinical documentation, DRG, level of care, coding, reimbursement, and U.S. payer requirements.

_**Qualifications:**_

**Required**

-   Bachelor’s degree in nursing, Healthcare Administration, Health Information Management, or related field.
-   Valid Philippine RN license/PRC registration for RN-required positions.
-   3 to 5 years of experience in U.S. healthcare RCM, clinical denials, CDI, utilization management, claims, or appeals.
-   Demonstrated experience leading or mentoring healthcare teams, preferably 20+ employees.
-   Strong knowledge of medical necessity, DRG, level of care, clinical documentation, coding, reimbursement, and U.S. payer policies.
-   Strong communication, analytical, problem-solving, and people-management skills.
-   Willingness to work U.S.-aligned shifts as required.

**Preferred**

-   CDAS or equivalent denial management credential.
-   CCDS/CDIP or equivalent CDI certification.
-   CCS/CPC or equivalent coding certification.
-   Experience with Epic and U.S. payer portals.
-   Experience managing denial inventory and performance dashboards.

_**Duties and Responsibilities**_

**Team Leadership & Operations**

-   Leads daily activities of a team of **20+ Clinical Denials Specialists**.
-   Assigns and prioritizes denial inventory based on complexity, aging, financial impact, and payer requirements.
-   Monitors productivity, quality, turnaround time, and appeal outcomes.
-   Provides coaching, mentoring, and performance feedback.
-   Supports onboarding and training of team members.
-   Escalates operational, clinical, payer, and client issues to management.

**Denial Review & Appeals**

-   Reviews complex and high-dollar clinical denials.
-   Provides guidance on medical necessity, DRG, level of care, clinical validation, documentation, and coding-related denials.
-   Reviews appeal letters for accuracy, completeness, and supporting evidence.
-   Supports interpretation of U.S. payer policies and reimbursement requirements.
-   Collaborates with CDI, HIM, Coding, Utilization Management, and other RCM stakeholders.

**Quality & Denial Prevention**

-   Partners with QA to address quality findings and performance gaps.
-   Identifies recurring denial trends and opportunities for prevention.
-   Supports root-cause analysis and process improvement initiatives.
-   Ensures work complies with client requirements, payer policies, privacy, and organizational standards.

**Reporting & Stakeholder Management**

-   Reviews team performance reports and KPIs.
-   Communicates trends, risks, and action plans to management.
-   Supports client and internal meetings as required.
-   Maintains effective communication with U.S.-based stakeholders.

## Apply

[Apply at Tasq Staffing Solutions, Inc.](https://apply.workable.com/tasq-work/j/DAC6F3C3F1/apply)

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