
Clinical Appeals
3 weeks ago
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, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together
Primary Responsibility:
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to,
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Clinical Appeal Specialist
3 days ago
Quezon City, National Capital Region, Philippines ECLARO Full time ₱900,000 - ₱1,200,000 per yearECLARO is currently hiring Clinical Appeals Specialists (PHRN) for our BPO client in Bridgetowne.If you're interested, please send your resume toQualifications:Must be an active PHRN license holderAt least 1 year of clinical experience (hospital, clinic, or managed care setting)Minimum of 6 months of clinical process outsourcing experience, with strong...
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Clinical Appeals Specialist
3 days ago
Quezon City, National Capital Region, Philippines Pinnacle Intelligence Full time ₱900,000 - ₱1,200,000 per yearWe are seeking highly qualified professionals to join our team as Clinical Appeals Specialists (PHRNs). This role offers competitive compensation, bonuses, and the opportunity to work onsite in Quezon City.Role SummaryWe are looking to hire 10 Clinical Appeals Specialists (PHRNs) with an onboarding date of September 2, 2025. Candidates must complete all...
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Clinical Appeals RN
2 days ago
Makati City, National Capital Region, Philippines Stark Asia Solutions, Inc Full time ₱1,200,000 - ₱1,600,000 per yearClinical Appeals RN (Registered Nurse) – PHRN (NON-VOICE)Pay: ₱46,600.00 – ₱56,600.00 per monthStart Date: SeptemberWork Locations: Makati City and Taguig CityWhy Join Us?Be part of our company and achieve your life's best work. We offer competitive pay, excellent benefits, and long-term career opportunities in a supportive work...
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Clinical Appeals Specialist
3 days ago
Quezon City, National Capital Region, Philippines Lean Solutions Group Inc. Full time ₱1,200,000 - ₱6,000,000 per yearWe're looking for PHRNs to join our top BPO client in Quezon CityWhat We Offer:Salary: up to 50,000/monthSign-On Bonus: PHP 50,000 (paid in 3rd & 6th month)Work Setup: Onsite at Bridgetowne, Quezon CitySchedule: ShiftingQualifications:Active Philippine Registered Nurse (PHRN) licenseAt least 1 year of clinical nursing experience (hospital, clinic or managed...
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PHRN Clinical Appeals Specialist
3 days ago
Quezon City, National Capital Region, Philippines Private Advertiser Full time ₱600,000 - ₱1,200,000 per year**What we offer: Salary Package: PHP 50,000**Sign-On Bonus: PHP 50,000Work Setup: Onsite at Bridgetowne, Quezon CitySchedule: Shifting Schedule Required Qualifications:An active Philippine Registered Nurse (PHRN) license is required.At least 1 year of clinical nursing experience (hospital, clinic, or managed care setting).A minimum of 6 months of Clinical...
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Clinical Appeals, PH Registered Nurse
1 day ago
Makati City, National Capital Region, Philippines Stark Asia Solutions, Inc Full time ₱56,000 - ₱560,000 per yearHiring Position: PHRN Clinical AppealsWe offer:Up to 56k Salary PackagePure Non-voice accountNight DifferentialHybrid; US Holidaysother Perks & BenefitsQualifications:Active PHRN license with 2-3 years clinical exp-bed side, critical care in Tertiary Hospital (ICU, CCU, Telemetry, Cardiovascular ICU, Medical ICU, ER, MS)WILL ASSIST YOU THROUGHOUT HIRING...
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Clinical Appeals Consultant
3 days ago
Makati City, National Capital Region, Philippines Optum Full time ₱2,000,000 - ₱2,500,000 per yearROLE AND RESPONSIBILITIESPosition in this function includes those responsible for management and administration of multiple Medical & Clinical Operations Functions, or managing general operations which are not specific to one of the functions in the Medical & Clinical Operations job family.Provides leadership to and is accountable for the performance of...
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NurseMedical InforSpecialistIV
3 days ago
Mandaluyong City, National Capital Region, Philippines MedRisk LLC Full time ₱900,000 - ₱1,200,000 per yearPosition Overview:The Nurse Utilization and Clinical Advisor Services Analyst IV is responsible for applying clinical expertise to drive improvements in healthcare resource utilization, cost, and quality. This role focuses on analyzing healthcare cases and claims, providing guidance on the appropriateness of care, and coordinating with clients and...
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Reimbursement Manager
4 weeks ago
Makati City, National Capital Region, Philippines AIA Hong Kong Full timeMediCard Phils., Inc. is one of the country's leading HMOs and the only HMO founded and run by doctors. Since its inception, the concept of service-oriented total health care has been MediCard's guiding principle. Despite the competitive landscape and tempting benefits offered by competitors, MediCard has maintained its lead by providing innovative and...
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Makati City, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time $104,000 - $130,878 per yearROLE AND RESPONSIBILITIESThe Clinical Appeals Nurse in Optum will ensure defensible and accurate case recommendations for concurrent admission, continued stay, and concurrent denial cases which are then reviewed by a Physician Advisor for completion of the concurrent and/or peer to peer review. They will be working directly with the Physician Advisors...