Clinical Denials Clinician

Recover revenue and drive process improvement as a Clinical Denials Clinician in a healthcare setting.Responsibilities include:Providing expertise to non-clinical personnel on clinical mattersCollaborating with leadership to develop and implement process improvementsAssisting in the development of policies and proceduresReviewing medical necessity cases and...

Clinical Denials Clinician recovers revenue through intelligent investigation of disputed claims, verifying eligibility, and preparing appeals based on industry-accepted criteria. They synergize with the Denials team on processes and best practices. Responsibilities include serving as a resource, providing process improvements, and performing medical...

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...

Clinical Denials and Appeals NurseWe are an analytics-driven, technology-enabled revenue cycle management company looking for a skilled Clinical Denials and Appeals Nurse with at least 1 year of relevant BPO experience. The ideal candidate will have a PHRN license, 6 months of hospital experience, and be willing to work a night shift...

Job Description**Summary:** Clinical Denials and Appeals Nurse with 1+ year BPO experience, PHRN license, and 6+ months hospital experience, willing to work onsite at McKinley West, Taguig, on a night shift schedule.**Responsibilities:*** Review inpatient and/or outpatient medical necessity and authorization denials to determine validity.* Conduct...

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...

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...

We are seeking a Registered Nurse with active license, at least 1 year of hospital bedside experience, and strong communication skills. Key advantages: Denials and Appeals writing experienceHealthcare BPO experienceBenefits of joining us:HMO on day 1Annual salary appraisalNon-taxable allowance20% night differentialFree shuttle service

Accesshealthcare is looking for REGISTERED NURSE to be part of our growing team!QualificationsMust be Registered Nurse with Active licenseAtleast 1 yr hospital bedside experienceExperience in Denials and Appeals writing is a definite advantageExperience in Healthcare BPO is a definite advantageGood communication skillsCan work onsite at McKinley, TaguigWhy...

Access Healthcare is looking for experienced Inpatient/Outpatient Medical Coders to join our PIONEER TEAM team. The ideal candidate will have at least 3 years of outpatient coding experience in one or more of the following specializations: Inpatient DRG, Clinical Documentation Specialist, Emergency Department (ED) Facility, Observation, Evaluation Management...

General ProfileUS REGISTERED NURSERequires knowledge and experience in the field.Will acquire higher-level knowledge and skills.Develops an understanding of the company, processes, and customers.Uses existing procedures to solve routine or standard problems.Receives moderate guidance and direction from others.Responsibility StatementsApplies medical judgment...

Join over 4000+ Healthcare Graduates who have trusted Shearwater CPO® - Home of Clinicians. Apply now so you can: Stay healthy with HMO upon hireGet Annual Salary Increase!Be secured with FREE Life Insured The responsibilities of a QA Specialist are as follows:Ensuring accuracy of information and quality of delivery by monitoring, auditing, reviewing,...

Registered Nurse Wanted: 1+ yr hospital bedside experience with good communication skills. Benefits include HMO, annual salary appraisal, non-taxable allowance, and free shuttle service.

Shift Schedule: Nightshift - 8PM-5AMWork Setup: Onsite - McKinley, Taguig Overview:A Radiology Prior Authorization Specialist plays a key role in ensuring that patients receive the necessary medical services, procedures, and imaging tests by obtaining insurance approval. This specialist navigates complex payer requirements, ensuring compliance and accurate...

Job Title: Medical Prior Authorization SpecialistAt Med Supply US, we are seeking a highly skilled Medical Prior Authorization Specialist to join our team. As a key member of our healthcare team, you will play a crucial role in ensuring that medical services, procedures, and medications are approved by insurance companies or third-party payers before they...

Medical Prior Authorization-Insurance Verification SpecialistPosition Summary:The Prior Authorization Specialist plays a crucial role in the healthcare industry by ensuring that medical services, procedures, and medications are approved by insurance companies or third-party payers before they are rendered or prescribed. They work closely with healthcare...

OPPORTUNITY HIGHLIGHTS St. Peter's Health Partners Medical Associates is seeking a full-time Nocturnists to join our employed hospitalist group at Samaritan Hospital in Troy, NY and St Peter's Hospital in Albany, NY. The selected candidate will join an established, directly employed, hospital medicine program. Enjoy excellent colleagues, strong...