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Clinical Appeals
2 days ago
Non-negotiable Qualifications:
Must have an active PHRN/USRN license
Must have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs)
Knowledgeable in medical terminology, anatomy, and physiology
With experience in reviewing pre/post-service denials, medical necessity reviews, and completing appeals and/or coordinating peer-to-peer reviews.
Understanding of healthcare regulations and compliance
Excellent English comms skills
Fast and stable internet connection - at least 50 Mbps
Willing to work the night shift
Amenable to work on a temporary WFH setup (Pasig - Must be residing within Metro Manila or near area)
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Clinical Appeals Nurse
2 months ago
Pasig, Philippines RSD Human Resource Management Consultancy Full timeAs a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...
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Clinical Appeals Nurse
2 months ago
Ortigas, Pasig, Philippines RSD Human Resource Management Consultancy Full timeAs a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...
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Clinical Appeals Nurse
2 months ago
Ortigas, Pasig, Philippines RSD Human Resource Management Consultancy Full timeAs a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...
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Clinical Appeals Nurse
2 weeks ago
Ortigas, Pasig, Philippines RSD Human Resource Management Consultancy Full timeAs a Clinical Appeals Nurse, you will be responsible for reviewing denied claims and treatment requests to ensure appropriate reimbursement for medical services rendered. You will analyze medical records, insurance policies, and clinical guidelines to develop compelling appeals for denied claims. Your expertise in healthcare regulations and reimbursement...
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Clinical Appeals PHRN
2 weeks ago
Pasig, Philippines TASQ Staffing Solutions Full timeTASQ Staffing Solutions is looking for a Clinical Appeals PHRN - Quality Analyst in Pasig. License/Certification Requirement: PHRN Work Arrangement: Temp WFH, hybrid or onsite Training: Temporary WFH Qualifications -Clinical Appeals QA: 1 year (Required) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in reviewing pre/post...
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Clinical Appeals USRN
2 weeks ago
Pasig, Philippines TASQ Staffing Solutions Full timeTASQ Staffing Solutions is looking for a Clinical Appeals USRN - Quality Analyst in Pasig. License/Certification Requirement: USRN Shift Schedule: PM Work Arrangement: Temp WFH, hybrid or onsite Training: Temporary WFH Experience: - Clinical Appeals QA: 1 year (Required) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in...
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Clinical Appeals PHRN
2 weeks ago
Pasig City, Philippines TASQ Staffing Solutions Full timeTASQ Staffing Solutions is looking for a Clinical Appeals PHRN - Quality Analyst in Pasig.License/Certification Requirement: PHRNWork Arrangement: Temp WFH, hybrid or onsiteTraining: Temporary WFHQualifications-Clinical Appeals QA: 1 year (Required)- Knowledgeable in medical terminology, anatomy, and physiology- With experience in reviewing pre/post service...
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Clinical Appeal Audit/QA
2 weeks ago
Ortigas Pasig City, Philippines RSD Human Resources Management Consultancy Full time"Experience: Clinical Appeals QA: 1 year (Required) Knowledgeable in medical terminology, anatomy, and physiology With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews. Understanding of healthcare regulations and compliance"SALARY PACKAGE 42, ,000
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Clinical Appeals PHRN
2 weeks ago
Pasig, Philippines TASQ Staffing Solutions Full timeLicense: PHRN Experience: - Clinical Appeals in BPO or hospital setting (utilization review acceptable) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews. - Understanding of healthcare regulations...
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Clinical Appeals PHRN
2 days ago
Pasig, Philippines TASQ Staffing Solutions Full timeLicense: PHRN Experience: - Clinical Appeals in BPO or hospital setting (utilization review acceptable) - Knowledgeable in medical terminology, anatomy, and physiology - With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews. - Understanding of healthcare regulations...
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Clinical Appeals PHRN
2 weeks ago
Pasig City, Philippines TASQ Staffing Solutions Full timeLicense: PHRNExperience: - Clinical Appeals in BPO or hospital setting (utilization review acceptable)- Knowledgeable in medical terminology, anatomy, and physiology- With experience in reviewing pre/post service denials, medical necessity review, and completing appeals and/or coordinating peer to peer reviews.- Understanding of healthcare regulations and...
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Clinical Appeals
2 weeks ago
Pasig, Philippines TASQ Staffing Solutions Full timeTemporary WFH setup w/ SOB - 20k for PHRNs and 30k for USRNs *terms and conditions apply Non-negotiable Qualifications: Must have an active PHRN/USRN license Must have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs) Knowledgeable in medical terminology, anatomy, and physiology With...
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Clinical Appeals
2 weeks ago
Pasig City, Philippines TASQ Staffing Solutions Full timeTemporary WFH setup w/ SOB - 20k for PHRNs and 30k for USRNs *terms and conditions applyNon-negotiable Qualifications:Must have an active PHRN/USRN licenseMust have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs)Knowledgeable in medical terminology, anatomy, and physiologyWith...
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Accounts Receivable Specialist
2 months ago
Ortigas, Pasig, Philippines VISAYA Full timeThe AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...
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Accounts Receivable Specialist
4 weeks ago
Ortigas, Pasig, Philippines VISAYA Full timeThe AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...
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USRN Team Leader
2 weeks ago
Pasig, National Capital Region, Philippines Cobden & Carter International Full timeWe are in need of USRN Team LeaderWork Location: OrtigasQUALIFICATIONS:at least 1 year of US Healthcare experience in utilization management reviewUSRN license and BPO healthcare UMR and clinical appeals with clinical hospital experienceany USRN state licensure is fine as long as the license is activeCan work onsite in Ortigas, PasigSALARY: Up to 75k...
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Medical Claims AR Specialist
2 months ago
Ortigas, Pasig, Philippines Visaya KPO Full timeThe AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...
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Medical Claims AR Specialist
4 weeks ago
Ortigas, Pasig, Philippines Visaya KPO Full timeThe AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...
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Accounts Receivable Specialist
4 weeks ago
Ortigas, Pasig, Philippines VISAYA Full timeThe AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...
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Accounts Receivable Specialist
2 months ago
Ortigas, Pasig, Philippines VISAYA Full timeThe AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...