Clinical Appeals Nurse

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...

-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...

"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...

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...

Qualifications:Candidate must possess at least a Bachelor's/College Degree in BS NursingRegistered NurseApplicants must be willing to work in Clinic Set-up (Location: Ortigas)No work experience requiredDuties:Identify patients' care requirements, focus on their needs and act on themNurture a compassionate environment by providing psychological supportResolve...

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...

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...

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...

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...

Qualifications: Candidate must possess at least a Bachelor's/College Degree in BS Nursing Registered Nurse Applicants must be willing to work in Clinic Set-up (Location: Ortigas) No work experience required Duties: Identify patients’ care requirements, focus on their needs and act on them Nurture a compassionate environment by providing psychological...

The OHN is responsible for promoting and ensuring the health and well-being of JFP employees, clinic management, first aid treatment, and providing professional nursing care to all JFP employees who were injured and sick at work, etc. related to health and safety. Qualifications: Graduate of BS in Nursing. Registered nurse (w/ active PRC License), with...

Responsibilities: Provide Basic Healthcare - The bulk of a company nurse’s day is used providing basic healthcare needs to a company’s employees. This includes administering first aid where needed and evaluating employees’ overall health. Administer Prescribed Medication and Treatment - Some employees may have medication and treatment that needs to be...