Clinical Appeals

3 weeks ago

Quezon City, Philippines RSD Human Resource Management Consultancy Full time
Skillset Required

Audit/Quality Analyst

License/Certification Requirement

PHRN

Shift Schedule

AM

Work Arrangement

Temp WFH, hybrid or onsite

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

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