Medical Adjudication Specialist

About the JobHive Health is revolutionizing access to quality, affordable healthcare in the Philippines, and we need talented professionals like you to help us achieve our mission. As a Medical Adjudication Specialist, you will be responsible for reviewing, analyzing, and validating medical availments and claims to ensure accuracy, compliance, and timely...

About the RoleWe are seeking a highly skilled Medical Adjudication Specialist to join our team at Hive Health. As a key member of our operations department, you will play a crucial role in optimizing healthcare delivery by meticulously reviewing, analyzing, and validating medical availments and claims.In this position, you will work closely with other...

Job DescriptionThe Medical City seeks an experienced Revenue Cycle Strategist to drive revenue generation and cash flow across the hospital group's network. This role requires a deep understanding of healthcare financing, payer relationships, billing processes, and data-driven decision-making.Main ResponsibilitiesLead and oversee all revenue cycle processes,...

What We OfferWe are committed to supporting the growth and well-being of our employees. As a Medical Adjudication Specialist at Hive Health, you can expect:Comprehensive healthcare coverage for you and your dependents from day one.Paid time off and flexible working arrangements to promote work-life balance.Mentorship, career development opportunities, and...

Optum is seeking a Medical Coding Specialist to join our team in Makati. This role requires active CPC-A or any equivalent medical coding certification, as well as a willingness to work in a hybrid setup with fixed weekends off.The ideal candidate will be able to report onsite during training and perform non-voice tasks. If you are passionate about...

Job Overview:The Clinical Application Specialist plays a vital role in ensuring the successful adoption of hospital equipment in healthcare facilities. This specialist will work closely with the sales team to meet target sales per assigned area while guaranteeing customer satisfaction and product effectiveness.Main Responsibilities:Assist support to sales...

We are seeking a highly skilled Medical Claims Specialist to join our team at Med-Metrix. As a key member of our claims department, you will be responsible for reviewing and processing medical claims, resolving any issues or discrepancies, and ensuring timely payment to providers.Key Responsibilities:Reviewing and processing medical claims, identifying any...

We are looking for a Medical Support Specialist to support our clients in the healthcare industry.About the Role:Respond to inquiries, appointments, and data verification requests from patients, providers, and healthcare insurance companies.Manage emails and voicemails while providing administrative support.Use Electronic Medical Records Systems to obtain...

Job DescriptionMED-METRIX is a dynamic and growing company that specializes in healthcare services. We are seeking a skilled Medical Appeals Specialist to join our team.This role involves reviewing insurance claims denied for payment on behalf of our client hospitals. The successful candidate will work closely with nurses and other team members to create...

Welcome to Santaisabel, a leading company in the health and wellness industry. We are excited to announce that we are hiring a Medical Vaccine Representative Specialist to join our dynamic team.About the Role:As a Medical Vaccine Representative Specialist, you will be responsible for promoting our vaccine products to healthcare professionals.You will work...

Job DescriptionThe Medical Chart Preparation Specialist plays a critical role in enhancing care quality and operational efficiency by accurately reviewing and transferring critical patient medical history from previous Electronic Health Record (EHR) systems into the new EHR platform.This position requires a high level of accuracy in reviewing and entering...

Company OverviewDISTRIPHIL is a reputable distributor of healthcare products in the National Capital Region, committed to providing quality solutions for health and wellness.Job DescriptionWe are seeking a highly skilled Medical Sales Specialist to establish strong relationships with healthcare professionals (HCPs) and patients in our service area. The ideal...

Job DescriptionThe Polytechnic University of the Philippines is seeking a skilled Clinical Applications Specialist 2 to join its team. As a key member of our sales team, you will provide professional support to our medical device sales specialists.About the RoleProduct Demonstrations and Training: You will deliver product demonstrations and training to...

The Medical City is seeking a highly skilled Technical Network Specialist to join its team. This critical role involves designing, implementing, maintaining, and optimizing the organization's network infrastructure to ensure its reliability, security, and compliance with industry regulations.This position requires strong technical expertise in network...

On-site - Pasig 1-3 Yrs Exp Diploma Full-timeJob DescriptionDescriptionJob SummaryThe Clinical Application Specialist (CAS) plays a key role in assisting sales and ensuring the successful adaptation of hospital equipment in healthcare facilities. The role involves engaging with hospitals and clinics, demonstrating medical equipment, and providing technical...

The Medical City Ortigas is searching for an experienced Product Marketing Specialist to join the team and help lead the organization to the next level. This role is crucial for identifying new business opportunities that align with The Medical City's strategic goals. They are responsible for providing data to support business cases and monitoring project...

Key ResponsibilitiesProvide clinical guidance to complex cases to facilitate approvals of medical availments.Review, adjudicate, and approve cases related to inpatient discharges, ensuring accurate coverage decisions and smooth patient transitions.Take the lead in providing critical weekend and after-hours support, ensuring urgent cases are managed promptly...

The Medical City seeks a highly skilled and experienced professional to fill the position of Quality and Operations Specialist.About the RoleThis is an exciting opportunity for a motivated and experienced individual to drive quality and operations initiatives across various departments and units. The successful candidate will be responsible for reviewing...

Job OverviewWe are seeking an experienced Medical Affairs Advisor to join our team at Getz Pharma Philippines. This role will provide scientific and academic support to internal and external customers while planning and managing medical-marketing activities.Main Responsibilities:Development and Execution of Medical Affairs Strategy and Tactical PlansDevelop...

The Medical Coding Trainer is responsible for providing training for both new and existing coders.Duties And Responsibilities:Assists in developing modules for medical coding training (CD-10-CM, CPT, HCPCS)Maintains knowledge on ICD 10 CM, ICD 10 PCS, CPT and HCPCS coding guidelinesUpdates existing training modulesDevelops and produce materials for inpatient...