Clinical Denials
4 days ago
Clinical Denials & Appeals Trainer Join MicroSourcing as a Clinical Denials & Appeals Trainer to provide end‑to‑end training for clinical denials and appeals processes within a BPO environment. You will facilitate training for new hires, cross‑train existing staff, and customize modules to client SLAs, payer guidelines, and EMR platforms. Location & Work Setup Taguig, Philippines – Onsite, Night shift Key Responsibilities Deliver process training covering assigned domains in Clinical Denials & Appeals. Facilitate induction, cross‑training, and refresher sessions for new hires and existing staff. Customize modules based on client SLAs, payer guidelines (Medicare, Medicaid, Commercial), and EMR platforms (Epic, Cerner, Meditech). Conduct assessments, quizzes, and feedback sessions to evaluate training effectiveness. Collaborate with Clinical SMEs and Operations to align content with performance expectations and compliance standards. Prepare and maintain training materials, SOPs, and documentation in compliance with client and audit requirements. Maintain training MIS (batch performance, attendance, feedback, certification data). Align training objectives with QA teams and production quality and accuracy goals. Track post‑training performance metrics such as speed‑to‑proficiency and productivity uplift. Participate in client calibration calls, internal audits, and process reviews to share training outcomes. Qualifications Minimum 1 year of experience delivering classroom or virtual training in clinical appeals writing within a BPO or healthcare setting. 3–5 years acute care clinical experience (Med/Surg or similar preferred; 2–3 years in ICU acceptable). Bachelor of Science in Nursing. Registered Nurse (PHRN or USRN) with an active license. Proficiency in InterQual or MCG clinical guidelines. Broad knowledge of U.S. Government Program and insurance regulations. Experience with EMR systems such as Epic, Cerner, or Meditech. Preferred Skills & Expertise Master’s degree or credential in business, healthcare, or related field. Certification in case management, clinical appeals, or clinical denials. Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, SharePoint). Experience using software for tracking denials and appeals. Strong facilitation, communication, and presentation skills with the ability to simplify complex concepts. Excellent attention to detail, analytical thinking, and decision‑making abilities. Demonstrated ability to work independently and collaboratively within a matrixed environment. High level of professionalism, integrity, and adaptability to changing client needs. Benefits Competitive above‑market compensation and performance bonuses. Healthcare coverage on day one for you and at least one dependent. Paid time‑off with cash conversion and group life insurance. Work‑life harmony with flexible arrangements. Opportunities for continuous learning and career advancement. Inclusive culture that celebrates diversity and fosters teamwork. About MicroSourcing With over 9,000 professionals across 13 delivery centers, MicroSourcing is the largest offshore provider of managed services in the Philippines. The company is committed to an inclusive culture that embraces individuals of all backgrounds and provides space for every team member to thrive. Terms & conditions apply. #J-18808-Ljbffr
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Clinical Denials
4 days ago
Taguig, Philippines MicroSourcing Full timeJoin to apply for the Clinical Denials & Appeals Manager role at MicroSourcing Discover your 100% YOU with MicroSourcing! Position: Clinical Denials & Appeals Manager Location: Taguig Work setup & shift: Onsite | Night shift Why join MicroSourcing Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one (for you and at least one...
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Clinical Denials
4 days ago
Taguig, Philippines MicroSourcing International, Inc. Full timeStart your adventure in the wonderful world of MicroSourcing by signing up now. Clinical Denials & Appeals QA Specialist Call Centre & Customer Service Customer Service BGC, Taguig Permanent / Full Time Position: Clinical Denials & Appeals QA Specialist Location: Taguig Work setup & shift: Onsite | Night shift Why join MicroSourcing? Competitive Rewards:...
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Clinical Denials
4 days ago
Taguig, Philippines MicroSourcing Full timeClinical Denials & Appeals QA Specialist Location: Taguig, Philippines. Work setup: Onsite, Night shift. Responsibilities Support the QA program build by identifying key audit areas, critical workflow aspects, and automation opportunities to enhance efficiency. Monitor performance metrics, including productivity and accuracy, for all Clinical Denials &...
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Clinical Denials
4 days ago
Taguig, Philippines MicroSourcing Full timeClinical Denials & Appeals Nurse Specialist - IP & OP Join to apply for the Clinical Denials & Appeals Nurse Specialist - IP & OP role at MicroSourcing Position: Clinical Denials & Appeals Nurse Specialist - IP & OPLocation: TaguigWork setup & shift: Onsite | Night shift Why join MicroSourcing? Competitive Rewards: Enjoy above-market compensation, healthcare...
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AR Clinical Denials Director
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Taguig, National Capital Region, Philippines ADI Group Full time ₱1,200,000 - ₱2,400,000 per yearPosition Summary - Responsible for Client operations including the execution of Clinical Denials. Also has overall responsibility for delivering on respective process metrics such as account cycle time and functions thereof, process cost and functions thereof, adherence to process standards, and process quality. This involves conducting continuous...
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PHRN – Clinical Authorization
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Taguig, Philippines Go-Get Data Consultancy Full timeOverview Job title: PHRN – Clinical Authorization Work set up: Onsite Opportunity – MCK Taguig, Cyber Sigma Building Work schedule: Weekdays Night Shift schedule, Fixed Weekends Off Salary: 45K to 50K package if licensed PHRN, salary for approval if non-licensed Responsibilities Contact insurance carriers to verify patient’s insurance eligibility,...
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Clinical Services Manager | ASAP
2 weeks ago
Taguig, Philippines HRTX Full timeQualifications Minimum of 5+ years of combined experience in direct patient care and/or a clinical administrator role (e.g., utilization management, clinical authorizations, clinical denials, or clinical documentation integrity) with a solid track record in reputable organizations. Registered Nurse (RN) or hold another clinical patient care designation....
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Taguig, Philippines MicroSourcing Full timeClinical Documentation Improvement Nurse Specialist – IP Location: TaguigWork setup & shift: Onsite | Night shiftCompany: MicroSourcing Benefits Competitive rewards with above‑market compensation, healthcare coverage on day one (for you and at least one dependent), paid time‑off with cash conversion, group life insurance, and performance bonuses....
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Taguig, Philippines HRTX Full timeWe're Hiring: PHRN Quality Auditor Clinical Services Location: Onsite, Mckinley, Taguig Schedule: Night Shift | Monday to Friday Hiring Target Date: Preferably by July 21, 2025 Salary Range: Up to 50k Qualifications Must hold an active PHRN license (Not a USRN holder) Prior experience as a Quality Auditor in a healthcare BPO clinical setting Alternatively, 4...
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Clinical Services Manager
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Taguig, National Capital Region, Philippines HRTX Full time $100,000 - $120,000 per yearQualifications:Experience & EducationMinimum of 5+ years of combined experience in direct patient care and/or a clinical administrator role (e.g., utilization management, clinical authorizations, clinical denials, or clinical documentation integrity) with a solid track record in reputable organizations.Registered Nurse (RN) or hold another clinical patient...
