Registered Nurse

3 hours ago


Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

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 compliance responsibilities, and other administrative duties as required.
  • Write compelling arguments based on clinical documentation and medical policies to submit appeals.
  • Resolve charge problems to ensure accurate billing and inform staff on proper practices.
  • Review and rectify errors in third-party payer reimbursement denials.
  • Actively manage denial or appeal activity and report trends to stakeholders.

Qualifications:

  • Active Registered Nurse license.
  • Hospital bedside experience in OR, ER, ICU, PACU, or General Wards.
  • Experience in BPO Healthcare account is an advantage.
  • Willing to work onsite.

About Access Healthcare:

  • We are a growing team seeking talented individuals.

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