Denials and Appeals Nurse | UMR | PHRN | Non-Voice | Pasay
2 days 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
6 days 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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Utilization Review Nurse – Denials and Appeals
18 hours ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱420,000 - ₱540,000 per yearJob description: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...
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Denials and Appeals Nurse
6 days 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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Clinical Denials and Appeals Nurse
1 week ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱480,000 - ₱540,000 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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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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PHRN for Non-Voice
18 hours ago
Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱900,000 - ₱1,200,000 per yearAccess Healthcare is looking for a Utilization and Clinical Denials Nurse to join our growing clinical account. The ideal candidate is a Licensed Philippines Nurse with at least one (1) year of hospital bedside experience and a strong understanding of utilization review, clinical documentation, and denial management in a BPO set-up. This role involves...
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Utilization Review Nurse | UMR | PHRN | Pasay
2 weeks ago
Pasay, Philippines Access Healthcare Services Manila, Inc. Full timeAccess Healthcare Services Manila, Inc. On-site - Pasay 1-3 Yrs Exp Bachelor Full-time Share Job Description We are seeking a highly skilled and detail-orientedPH Registered Nurse (PHRN) to join our team. The ideal candidate will have hands-on experience withInterQual ,MCG ,NCD , andLCD Guidelines Key Responsibilities Conduct clinical reviews of inpatient...
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Clinical Review Nurse – Denials
17 hours ago
Pasay, National Capital Region, Philippines access healthcare Full time ₱900,000 - ₱1,200,000 per yearJob description: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...
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Utilization Review Nurse | UMR | PHRN | Pasay
3 weeks ago
Pasay, Philippines Access Healthcare Full timeDirector Talent Acquisition at Access Healthcare Services We are seeking a highly skilled and detail-oriented PH Registered Nurse (PHRN) to join our team. The ideal candidate will have hands-on experience with InterQual , MCG , NCD , and LCD Guidelines Key Responsibilities Conduct clinical reviews of inpatient and outpatient services using InterQual, MCG,...
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PHRN Clinical Trainer
1 week 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...
