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Taguig, National Capital Region, Philippines JPRecruits Full timeKey ResponsibilitiesDenial review: Analyze denial letters and medical records to determine the cause of rejection.Appeal preparation: Draft evidence-based appeals using clinical knowledge, guidelines (MCG/InterQual), and payer rules to justify medical necessity.Information collection: Coordinate with healthcare providers to secure required documentation for...
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Clinical Review Nurse
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Taguig, Philippines MicroSourcing Full timeClinical Review Nurse – Denials & Appeals Position: Clinical Review Nurse – Denials & Appeals 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 dependent), paid time‑off with cash conversion, group life...
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Denials Management Manager
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Denials & Appeals Program Lead
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Taguig, Philippines MicroSourcing Full timeJoin to apply for the Denials & Appeals Program Lead role at MicroSourcing Position: Denials & Appeals Program Lead 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 dependent), paid time‑off with cash conversion,...
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Healthcare Denials Management Nurse
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Taguig, National Capital Region, Philippines Private Advertiser Full timeWe are seeking a Registered Nurse to join our dynamic and growing team. In this role, you will ensure the completion of assigned patient cases through roll calls, concurrent and retrospective clinical reviews, and processing surgery authorizations as needed.Key ResponsibilitiesConduct advanced-level work related to clinical denials and utilization...
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AR Clinical Denials Director
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Taguig, Philippines MicroSourcing Full timeDenials Quality Assurance Specialist Position: Denials Quality Assurance Specialist 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 dependent), paid time-off with cash conversion, group life insurance, and...
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Taguig, Philippines MicroSourcing International, Inc. Full timeDenials Management Learning Specialist Location: Taguig Work setup & shift: Onsite | Night shift Application Deadline: 11/11/2025 Benefits Competitive Rewards: 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. A Collaborative...
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Denials Quality Assurance Specialist
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Taguig, Philippines MicroSourcing International, Inc. Full timeDenials Quality Assurance Specialist Location: Taguig Work setup & shift: Onsite | Night shift Employment type: Permanent / Full Time Open until 11/11/2025 Why Join MicroSourcing? Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one (for you and at least one dependent), paid time-off with cash conversion, group life insurance,...
Clinical Denials
4 weeks 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
