Denials and Appeals Nurse w/ 50k Sign On Bonus

QualificationsAt least 1 year of relevant BPO experience as a Clinical Denials and Appeals NurseMinimum of 6 mos hospital experiencePHRN licenseWilling to report onsite (McKinley West, Taguig) and on a night shift scheduleResponsibilitiesEffectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the...

Make your next big career move by applying as KMC Solutions’ next PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN)!The main responsibilities of a PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN) include:Effectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the validity of such denials in a timely...

QualificationsAt least 1 year of relevant BPO experience as a Clinical Denials and Appeals NurseMinimum of 6 mos hospital experiencePHRN licenseWilling to report onsite (McKinley West, Taguig) and on a night shift scheduleResponsibilitiesEffectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the...

Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...

Make your next big career move by applying as KMC Solutions' next PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN)The main responsibilities of a PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN) include:Effectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the validity of such denials in a timely...

SUMMARYThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on industry-accepted criteria. He / She is also relied on when it comes to...

SUMMARYThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on industry-accepted criteria. He / She is also relied on when it comes to...

Registered Nurse needed to ensure completion of patient cases by conducting roll calls, processing clinical reviews, and authorizing surgeries. Key Responsibilities: Perform advanced clinical denial and utilization management work. Manage medical denials through comprehensive review of clinical documentation. Handle audit and...

Job PurposeThe Appeal Writer supports the Company by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Appeal Writer creates appeal letters in support of claim payment.Duties and ResponsibilitiesReview denied insurance claimsReview patients’ medical filesDevelop...

Role DescriptionThis is a full-time on-site role for a Medical Biller located in Makati. The Medical Biller will be responsible for processing of claims for a chain of pediatrics clinics in USA. ensuring that we get paid by insurance, denial investigation and resubmission, A/R recovery.Medical Biller (outpatient)DutiesPosting of payment and downloading...

Job Summary: The Appeal Writer reviews denied insurance claims, creates appeal letters, and manages workflow to support claim payment. The Appeal Writer plays a crucial role in supporting our client hospitals by reviewing denied insurance claims and creating appeal letters to secure payment. This position requires strong writing skills, attention to detail,...

MUST BE PHRN 2 yrs w/o clinical experienceMinimum 1 yr UMR and or pre auth experience with knowledge of denials and medical necessity guidelines-1 yr w/ clinical experience (bedside Medical Surgical, ER or OR)-1yr BPO w/ clinical experience or 2yrs BPO w/o clinical experience Offer :PHRN UMR- up to 50k package Temp WFH USRN UMR - up to 75k ( onsite )

Urgent Hiring! Registered Nurses Qualifications: - 1 year of Clinical/Bedside Experience - With good communication skills - with an active PRC License We Offer: - Signing Bonus - HMO up to 3 dependents - 20% night differential - 13th and 14th-month pay - Generous leave benefits - Relocation assistance to make your transition smoother Job...

The Clinical Trainer will be responsible for delivering training programs within Access Healthcare's Utilization Management account. The ideal candidate must possess a strong background in Utilization Management, Clinical Denials, and Appeals, with a focus on enhancing the skills and knowledge of our team to ensure high-quality service delivery.Key...

Urgent Hiring! Registered Nurses Qualifications: - 1 year of Clinical/Bedside Experience - With good communication skills - with an active PRC License We Offer: - Signing Bonus - HMO up to 3 dependents - 20% night differential - 13th and 14th-month pay - Generous leave benefits - Relocation assistance to make your transition smoother Job...

DMW License No: DMW-261-LB-02142024-RAccreditation No: 10454458Job Description: You will work closely with nurses, and other healthcare professionals to deliver quality care to patients.Perform of daily nursing care routine. Record vital signs, assist in wound dressing, perform blood glucose testing and specimens' collection, assist patients with general...

Seeking a Clinical Trainer to deliver training programs within Access Healthcare's Utilization Management account, enhancing team skills and knowledge in Utilization Management, Clinical Denials, and Appeals. The ideal candidate will possess a strong background in Utilization Management, Clinical Denials, and Appeals, with a focus on high-quality service...

Essential Duties & ResponsibilitiesVerify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providersUpdate patient demographics/insurance information in appropriate systemsResearch/ Status unpaid or denied claimsMonitor claims for missing information, authorization, and...

DMW License No: DMW-261-LB RAccreditation No:Job Description: You will work closely with nurses, and other healthcare professionals to deliver quality care to patients.Perform of daily nursing care routine. Record vital signs, assist in wound dressing, perform blood glucose testing and specimens' collection, assist patients with general hygiene and in other...

This position is responsible for identifying, capturing, tracking, reviewing, and resolving held claim edits, claim rejections, and/or denials that result from the claims/billing cycle.  This position ensures all resolutions utilized are in accordance with policies, procedures, official coding guidelines/advice, rules and regulations (payer, state, and/or...