Clinical Appeals

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 inclusion, talented peers,...

A global healthcare organization is seeking a Mid-Level Medical Doctor in Makati. The role requires an active medical license and 5+ years of operations management experience. Responsibilities include compliance with company policies and leading teams. Candidates must have strong analytical and communication skills. This full-time position necessitates...

Reimbursement Manager page is loaded## Reimbursement Managerlocations: Makati, PH-MPItime type: Full timeposted on: Posted 30+ Days Agojob requisition id: JR-50124**MediCard Phils., Inc.** is one of the country's leading HMO and the only HMO founded and run by Doctors. Since its inception, the concept of service-oriented total health care has been the...

Overview PHRN - ICU/ER Experience Required in a Tertiary Hospital | Hybrid Work Set-up. Optum Makati, National Capital Region, Philippines. Responsibilities The 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...

Psychiatry Wellness Center is looking for a Virtual Mental Health Medical Coder/Biller/Collections Specialist. We are looking for a top performer with previous experience and knowledge of billing, reimbursement, and payment posting. The Medical coder is responsible for accurately and efficiently coding medical diagnoses and procedures for a psychiatry...

ROLE 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...

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