Clinical Denials Specialist

Performs advanced level work related to clinical denial management. The individual isresponsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, andothers as assigned.

Certified Coder: CPC/COC/CIC/CCA/CCS-P/CCSWorking Set up : Temp WFH, hybrid or onsite 1. Bachelor of Science in Nursing graduate or Medical Allied Health Course 2. Preferrably with work experience in a. Revenue Cycle (medical coding) experience. b. Knowledge of medical and billing terminologies, ICD-10 diganosis coding guidelines, CPT procedures. c....

Pharmaceuticals & Medical Devices (Healthcare & Medical) Full time Add expected salary to your profile for insights The Clinical Applications Specialist (CAS) is responsible for providing professional support to our medical device sales team. The support takes on many forms and shapes, ranging from technical support with our devices/equipment to clinical...

The Clinical Applications Specialist (CAS) is responsible for providing professionalsupport to our medical device sales team. The support takes on many forms and shapes, rangingfrom technical support with our devices/equipment to clinical application questions across awide range of indications, to product training and application support online or hospital...

We are seeking a highly skilled and motivated Loan Application Specialist to join our dynamic team in US. It's a leading financial institution dedicated to providing excellent financial services to our customersAs a Loan Application Specialist, you will contribute to maintaining accurate records, adhering to compliance guidelines and staying updated on...

Responsible in performing accounting tasks such as recording all sales, purchases and other related transactions in the general ledger system to produce financial reports per clinic assigned in accurate and timely mannerJob Responsibilities:Records sales transactions per assigned clinic to ensure proper and accurate income and expense reports.Ensures that...

Responsible in performing accounting tasks such as recording all sales, purchases and other related transactions in the general ledger system to produce financial reports per clinic assigned in accurate and timely manner.Job Responsibilities:Records sales transactions per assigned clinic to ensure proper and accurate income and expense reports.Ensures that...

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 systems Research/ Status unpaid or denied claimsMonitor claims for missing information, authorization, and control...

The Role:The Sr. Team Leader is responsible for the solid overall workforce and client management, and will take full ownership on supervising and motivating team members. To succeed you will need to be professionally focused on optimizing department processes and building lasting relationships with stakeholders.Duties and Responsibilities:Oversee a team of...

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 systems Research/ Status unpaid or denied claimsMonitor claims for missing information, authorization, and control...

Job Description: Hemodialysis Head Nurse/Nursing Care CoordinatorPosition: Hemodialysis Head Nurse/Nursing Care CoordinatorCompany: Nephrology Center of Pasig City, Inc. - 2Location: Marcos Highway, Brgy. Mayamot, Antipolo, RizalQualifications:1. Registered Nurse with a valid license from PRC.2. Minimum of 2 years of nursing experience, with at least 1 year...

Quality Assurance Team Lead (US Healthcare) | ManilaTo provide direction and support to SQ and Process improvement team to perform defined set of activities which result in systemic solutions leading to continual and breakthrough improvement of service delivery.· Manage a team of 5-10 SQ TLs spread across different LOBs.· Coach, guide and support Quality &...

Start your adventure in the wonderful world of MicroSourcing by signing up now. Search Jobs Revenue Cycle ManagerHealthcare & MedicineOtherOrtigas, Pasig CityPermanent / Full Time5/6/2024 Manager is responsible for managing the Insurance Accounts Receivable Representative's primary responsibility is to provide the highest quality of customer service and...

CSR for Healthcare Account/s (Authorization Specialist) GeBBS Healthcare Solutions (Philippines), Inc. DUP2 Full time Add expected salary to your profile for insights An Authorization Specialist plays a crucial role in the healthcare industry, ensuring that patients receive the necessary approvals for medical services and treatments. Duties and...

Medical Administration (Healthcare & Medical) Full time Add expected salary to your profile for insights The Patient Accounts Receivable Representative (PAR) performs a variety of basic to moderately complex tasks related to posting payments, adjustments and transfers to the billing and collection system in a timely and accurate manner. Print daily...

Help Desk & IT Support (Information & Communication Technology) JOB SUMMARYProvides first/second level support related to the functionality and technical set up of the product.DUTIES & RESPONSIBILITIES● Ensure customer satisfaction by actively participating in the timely and quality resolution of issues as per agreed SLA's (may require travel to customer...

Responsible for working hand-in-hand with our technology partners on the following stages of the project: Business Requirements Study (BRS), Super User Training, User Acceptance Testing, End to End Testing, End User Training, Pre Go Live and Post Go Live Support.DUTIES & RESPONSIBILITIES● Ensures customer satisfaction through timely and quality delivery of...

Global Total Rewards Manager/Total Rewards Manager Remuneration & Benefits (Human Resources & Recruitment) Full time Add expected salary to your profile for insights Transcom is looking for talented individuals like you to join our awesome team Be the next Global Total Rewards Manager or PH Total Rewards Manager for our Transcom Pasig site.Join our...

Performs advanced level work related to clinical denial management. The individual isresponsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, andothers as assigned.

License: PHRN Experience: - Clinical Appeals in BPO or hospital setting (utilization review acceptable) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews. - Understanding of healthcare regulations...

License: PHRN Experience: - Clinical Appeals in BPO or hospital setting (utilization review acceptable) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews. - Understanding of healthcare regulations...

License: PHRNExperience: - Clinical Appeals in BPO or hospital setting (utilization review acceptable)- Knowledgeable in medical terminology, anatomy, and physiology- With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews.- Understanding of healthcare regulations and...

TASQ Staffing Solutions is looking for a Clinical Appeals PHRN - Quality Analyst in Pasig. License/Certification Requirement: PHRN Work Arrangement: Temp WFH, hybrid or onsite Training: Temporary WFH Qualifications -Clinical Appeals QA: 1 year (Required) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in reviewing pre/post...

TASQ Staffing Solutions is looking for a Clinical Appeals USRN - Quality Analyst in Pasig. License/Certification Requirement: USRN Shift Schedule: PM Work Arrangement: Temp WFH, hybrid or onsite Training: Temporary WFH Experience: - Clinical Appeals QA: 1 year (Required) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in...

"Experience: Clinical Appeals QA: 1 year (Required) Knowledgeable in medical terminology, anatomy, and physiology With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews. Understanding of healthcare regulations and compliance"SALARY PACKAGE 42, ,000

TASQ Staffing Solutions is looking for a Clinical Appeals PHRN - Quality Analyst in Pasig.License/Certification Requirement: PHRNWork Arrangement: Temp WFH, hybrid or onsiteTraining: Temporary WFHQualifications-Clinical Appeals QA: 1 year (Required)- Knowledgeable in medical terminology, anatomy, and physiology- With experience in reviewing pre/post service...

Temporary WFH setup w/ SOB - 20k for PHRNs and 30k for USRNs *terms and conditions apply Non-negotiable Qualifications: Must have an active PHRN/USRN license Must have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs) Knowledgeable in medical terminology, anatomy, and physiology With...

Temporary WFH setup w/ SOB - 20k for PHRNs and 30k for USRNs *terms and conditions apply Non-negotiable Qualifications: Must have an active PHRN/USRN license Must have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs) Knowledgeable in medical terminology, anatomy, and physiology With...

Temporary WFH setup w/ SOB - 20k for PHRNs and 30k for USRNs *terms and conditions applyNon-negotiable Qualifications:Must have an active PHRN/USRN licenseMust have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs)Knowledgeable in medical terminology, anatomy, and physiologyWith...

Open positions:Inpatient CoderOutpatient Coder Salary: 50, ,000Outpatient Coding Trainer Salary: 59,700Clinical Denials QACDISpecialist Salary: 35, ,000 Qualifications:PHRN - Certified Medical Coder (COC, CCS, CPC, CIC and etc.

The AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...

The AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...

The AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...

The AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...

The AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...

The AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...

The AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...

The AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...