Clinical Denial Specialist
3 weeks ago
The Clinical Denial Specialist writes and submits professionally written appeals which include compelling arguments based on clinical documentation, third-party payer medical policies, and contract language. Appeals are submitted timely and tracked through final outcome.
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Clinical Denial Lead
3 weeks ago
Rizal, Philippines RSD Human Resource Management Consultancy Full timeThe Clinical Denial Specialist conducts comprehensive reviews of the claim denial, account/guarantor notes associated with the denial, and the medical record to make determinations if a revised claim needs to be submitted, if a retro authorization needs to be obtained, if a written appeal is needed, or if no action is .
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Clinical Denial QA
3 weeks ago
Rizal, Philippines RSD Human Resource Management Consultancy Full timePerforms advanced level work related to clinical denial management. The individual is responsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and others as assigned.
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Quality Assurance Specialist in medical coding
4 weeks ago
Rizal, Philippines RSD Human Resource Management Consultancy Full timethe Quality Assurance (QA) Specialist is responsible in ensuring accuracy of information and quality of delivery by monitoring, auditing, reviewing, analyzing, documenting work processes that further improves clinical operations standards. Performs quality audits, validates results and communicates recommendation among responsible departments. Participates...
