Clinical Appeals

3 weeks ago

Ortigas, Philippines RSD Human Resource Management Consultancy Full time
Skillset Required
Audit/Quality Analyst
License/Certification Requirement
USRN
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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