Denials and Appeals Nurse | UMR | PHRN | Non-Voice | Pasay
4 weeks ago
Access Healthcare is looking for REGISTERED NURSE to join our growing team. You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed. Responsibilities Perform advanced level work related to clinical denial and utilization management. Manage medical denials by conducting a comprehensive review of clinical documentation. Handle audit/compliance responsibilities and other administrative duties as required. Write compelling arguments based on the clinical documentation and the medical policies of the payer and submit appeals in a timely manner. Resolve charge problems to ensure accurate and complete billing, and inform staff on proper billing, follow-up, and documentation practices. Review and rectify errors in third party payer reimbursement denials based on documentation, billing accuracy, medical necessity, coding, modifier, and other related issues. Actively manage, maintain, and communicate denial or appeal activity to appropriate stakeholders and report suspected or emerging trends related to payer denials to Revenue Cycle management. Qualifications Must be Registered Nurse with Active license Hospital Bedside experience (OR / ER / ICU/ PACU / General Wards / After Surgery Care ) Experience in BPO Healthcare account is a definite advantage (Insurance, Denials & Appeals, Coding, Utilization Review, Prior Authorization, ETC) Must be amenable to work onsite at Pasay Can start ASAP We need talented individual like you, Apply Now #J-18808-Ljbffr
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Denials and Appeals Nurse
1 week ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱540,000 - ₱660,000 per yearAccess Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...
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Denials and Appeals Nurse
2 weeks ago
Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱900,000 - ₱1,200,000 per yearAccess Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed. Responsibilities :Perform advanced level work related to clinical denial and utilization...
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PH Registered Nurse Clinical Denial and Appeals
2 weeks ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱450,000 - ₱550,000 per yearAccess Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...
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Registered Nurse Associate | BPO
3 weeks ago
Pasay, Philippines HRTX Full timeAbout the job Registered Nurse Associate | BPO Position: PHRN AssociateLocation: Pasay (Onsite)Work Schedule: Night ShiftSalary: Up to 40,000 Qualifications: Registered Nurse with active PRC license Minimum of 1 year hospital bedside experience (OR, ER, ICU, PACU, General Wards, Post-Surgery Care, or acute hospital settings) At least 1 year of BPO healthcare...
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PHRN Clinical Trainer
2 weeks ago
Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱60,000 - ₱120,000 per yearThe role Access Healthcare Services Manila, Inc.' is seeking a experienced PHRN Clinical Trainer to join our UMR team based in Pasay City Metro Manila. This is a full-time position and will play a crucial role in delivering high-quality training to our clinical staff.Key responsibilitiesDevelop and deliver comprehensive training programs to ensure clinical...
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Pasay, Philippines access healthcare Full timeUtilization Management Specialist (PHRN /USRN - Non-Voice) Join our dynamic healthcare team and make an impact by improving patient outcomes, ensuring compliance, and driving efficient healthcare delivery for our global clients. ✅ Ideal Candidate Must be a Philippine Registered Nurse (PHRN/USRN) with an active license. 1–2 years of experience in...
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Company Nurse
4 weeks ago
Pasay, Philippines Reliasourcing Full timeOn-site - Pasay 1-3 Yrs Exp Bachelor Full-time Job Description Job Title: Company Nurse Location: Pasay City (Onsite) Employment Type: Full-Time The Company Nurse is responsible for providing quality occupational health care to employees and ensuring compliance with workplace health and safety standards. The role includes managing the company clinic,...
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Customer Service Representative
1 week ago
Pasay City, Philippines VCC Link, Inc. Full timeQualifications: • With 1-year clinical experience • With Active PRC License • Willing to work onsite in Pasay (MOA) and in night shift Job Description: • Handle patient or member inquiries via phone, email, or chat with professionalism and empathy. • Use nursing knowledge (PHRN scope) to gather clinical...
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Customer Service Representative
1 week ago
Pasay, MOA, Philippines VCC Link, Inc. Full timeQualifications: • With 1-year clinical experience • With Active PRC License • Willing to work onsite in Pasay (MOA) and in night shift Job Description: • Handle patient or member inquiries via phone, email, or chat with professionalism and empathy. • Use nursing knowledge (PHRN scope) to gather clinical information, provide basic health guidance,...
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Registered Nurse Associate
3 weeks ago
Pasay, Philippines HRTX Full timeRegistered Nurse Associate (PHRN) | HYBRID Location: MOA, PasayWork Arrangement: Onsite training for the first 3 months, then HYBRID . Night shift / shifting schedule.Salary: Up to 35,00037,000 Start Date: ASAP Qualifications: At least 2 years of solid Hospital Bedside experience Must hold an active PRC license Willing to work onsite during training and open...
