Clinical Denials Lead

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.

Skillset Required: OP CodingLicense/Certification Requirement:Certified Coder: CPC/COC/CIC/CCA/CCS-P/CCS-PM SHIFTWork Arrangement: Temp WFH, hybrid or onsiteTraining Arrangement: Temporary WFHCoding Skills Needed: ICD 10 CM (Diagnosis Coding) & CPT ProcedureRequirements:"1. Bachelor of Science in Nursing graduate or Medical Allied Health Course2. Preferrably...

As our business grows, we are looking to further strengthen our Clinical Operations team in IQVIA Philippines by hiring Clinical Research Associate (CRA). You will perform monitoring and site management work to ensure that sites are conducting the study(ies) and reporting study data as required by the study protocol, applicable regulations and guidelines,...

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...

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 &...

Discover a workplace that values your well-being and success. Enjoy competitive allowances, comprehensive HMO coverage, up to 30 days of paid time off, and exciting performance-based bonuses and incentives.We are seeking a highly skilled and experienced Medical Coding Team Leader to join our dynamic team. The ideal candidate will possess strong leadership...

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...

Provide leadership and guidance to offshore RCM Partners and their teams, reviewing processes and offering recommendations for operational improvementCollaborate on project work for all functions with offshore and ensure adherence to timely completion guidelines Maintain or surpass team productivity and quality standardsPartner with the Vice President to...

Skillset Required: IP Coding-Certified Coder: CPC/COC/CIC/CCA/CCS-P/CCS-MORNING SHIFT-Work Arrangement: Temp WFH, hybrid or onsite-Training Arrangement: Temporary WFH-Code Skills Needed: ICD 10 CM (Diagnosis Coding) & ICD 10 PCS Procedure CodingRquirements:"Education or equivalency: Bachelor's Degree in Medical Records or Allied Medical Field, or education...

Supervisors/Team Leaders (Call Centre & Customer Service) · Monitor activities of Nurses to assess schedule adherence, accuracy, quality, productivity, timeliness and compliance with job requirements, policies and procedures. Report updates to management.· Provide basic on-the-job training for direct reports and serve as a resource to address questions...

All Jobs > Manager, Operations AR Follow Up 1604 Metro Manila, PHL • Forensic Department Provide leadership and guidance to off-shore RCM Partners and their teams reviewing processes and providing recommendations for improvement of operations working towards our combined operational goal to meet or exceed national AR KPI benchmarks and client specific...

We are in need of USRN Team LeaderWork Location: OrtigasQUALIFICATIONS:at least 1 year of US Healthcare experience in utilization management reviewUSRN license and BPO healthcare UMR and clinical appeals with clinical hospital experienceany USRN state licensure is fine as long as the license is activeCan work onsite in Ortigas, PasigSALARY: Up to 75k...

Job PurposeProvide leadership and guidance to off-shore RCM Partners and their teams reviewing processes and providing recommendations for improvement of operations working towards our combined operational goal to meet or exceed national AR KPI benchmarks and client specific KPI's. Help support project work for all functions with offshore and ensure they are...

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...

Are you passionate about sales and aesthetics?Join our dynamic team as a Sales Manager and play a pivotal role in driving revenue growth and enhancing client satisfaction in the exciting field of aesthetics.Key Responsibilities:Develop and implement effective sales strategies.Build and maintain strong client relationships.Lead a sales team to achieve...

Educational Qualifications: Masteral Degree in MHA or MANExperience Level: At least 2 years of experience in Hospital/Clinic ManagementSkills and Competencies: Leadership, strategic planning, excellent communication, and decision-making skills.Responsibilities and Duties: Oversee company operations, set strategic goals, manage resources, and drive...

Educational Qualifications: Masteral Degree in MHA or MANExperience Level: At least 2 years of experience in Hospital/Clinic ManagementSkills and Competencies: Leadership, strategic planning, excellent communication, and decision-making skills.Responsibilities and Duties: Oversee company operations, set strategic goals, manage resources, and drive...

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...

We are looking to hire a passionate professional with significant experience andunderstanding of product marketing/management to jumpstart Philcare Pharma's entry into thenephrology segment of the local healthcare market.We are looking for dynamic professionals for the following specializations:Cardio-Metabolic CareAnesthesia & Critical CareThis position...