Clinical Appeals

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...

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...

"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"SALARY PACKAGE 42, ,000

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...

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...

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...

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...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

The AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...

The AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...

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...

Duties & Responsibilities Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims Monitor claims for missing information, authorization, and control...

The AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...

The AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...