Clinical Appeal Audit/QA

As a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...

As a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...

As a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...

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...

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...

-Must have PHRN licensed -Must have experienced in clinical appeals / Utilization Management -Research into current healthcare regulations and stipulations—to form the basis for any necessary appeal. Investigation into a patient's history treatment—to better warrant their need for continual care. Reviewing response letters from insurance carriers—and...

-Must have PHRN licensed -Must have experienced in clinical appeals / Utilization Management -Research into current healthcare regulations and stipulations—to form the basis for any necessary appeal. Investigation into a patient's history treatment—to better warrant their need for continual care. Reviewing response letters from insurance carriers—and...

Must have PHRN licensedMust have experienced in clinical appeals / Utilization ManagementResearch into current healthcare regulations and stipulations—to form the basis for any necessary appeal. Investigation into a patient's history treatment—to better warrant their need for continual care. Reviewing response letters from insurance carriers—and...

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...

As a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...

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...

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...

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...

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...

Job Purpose: Ensure that project related quality processes are followed by associates, client specific metrics and internal metrics are achieved, provide coaching to employees, track and trend data for improvement. Primary Duties and Responsibilities: We are currently looking for a keen individual who is responsible for conducting audits for healthcare...

Job Purpose: Ensure that project related quality processes are followed by associates, client specific metrics and internal metrics are achieved, provide coaching to employees, track and trend data for improvement. Primary Duties and Responsibilities: We are currently looking for a keen individual who is responsible for conducting audits for healthcare...

Job Purpose: Ensure that project related quality processes are followed by associates, client specific metrics and internal metrics are achieved, provide coaching to employees, track and trend data for improvement. Primary Duties and Responsibilities: We are currently looking for a keen individual who is responsible for conducting audits for healthcare...

Job Purpose: Ensure that project related quality processes are followed by associates, client specific metrics and internal metrics are achieved, provide coaching to employees, track and trend data for improvement. Primary Duties and Responsibilities: We are currently looking for a keen individual who is responsible for conducting audits for healthcare...