Clinical Appeals Nurse Start ASAP

3 weeks ago

Manila, National Capital Region, Philippines AGS health Full time

Qualifications

  • PH Registered Nurse with experience in doing medical necessity appeals, lack of authorization appeals.

  • Clinical authorization experience is preferred, but appeals experience is required.

  • Proficient in reading Explanation of Benefits (EOB) and investigating denial root causes.

  • Must be skilled in navigating various payer and provider portals.

  • Typing speed of at least 45 WPM.

  • Strong command of the English language, both spoken and written.

  • Willing to work night shifts to communicate with payers.

  • Familiarity with MCG and InterQual is a plus.

#J-18808-Ljbffr

  • Clinical Appeals Nurse

    2 weeks ago

    Manila, National Capital Region, Philippines Health Business Solutions Full time

    Join our dedicated team at HBiz where we strive to provide outstanding care and service excellence. We are currently seeking a highly skilled Clinical Appeals Nurse to play a crucial role in managing medical denials by providing clinical expertise in the appeals process. This position is ideal for those who excel in analytical thinking and have a strong...

  • Clinical Appeals Specialist

    1 week ago

    Manila, National Capital Region, Philippines beBee Careers Full time

    Clinical Appeals SpecialistWe are seeking a skilled Clinical Appeals Specialist to help resolve medical claim denials and ensure fair resolutions for patients and providers.This is a remote role with day shift hours, allowing for a consistent schedule.

  • Clinic Nurse

    3 weeks ago

    Manila, National Capital Region, Philippines Wellnostics Inc. Full time

    Job Title: Nurse (Reliever)Company: Next Health DiagnosticsLocation: BGC, Taguig City (Ground Floor, The Spa, B8, 9th Ave, Taguig, Metro Manila)About Us:At Next Health Diagnostics, we believe in the power of proactive healthcare – a paradigm shift from reactive medicine to a future where individuals are empowered with knowledge and tools to take charge of...

  • clinic nurse

    4 weeks ago

    Manila, National Capital Region, Philippines Laser Aesthetis & Vision Institute Full time

    WE ARE AN OPHTHALMOLOGY SURGICAL CLINIC IN NEED OF A CLINIC NURSE WHO WILL ASSIST IN THE TREATMENT AND CARE OF OUR OUTPATIENT DEPARTMENT.THE CANDIDATE WILL BE TRAINED IN OPHTHALMOLOGIC NURSING AS WELL AS ASSISTING IN OPERATING ROOM PROCEDURES.How do your skills match this job?Your application will include the following questions:What's your expected monthly...

  • Clinical Management Specialist

    2 days ago

    Manila, National Capital Region, Philippines beBee Careers Full time

    This position requires a Registered Nurse with an active license to perform advanced-level work related to clinical denial and utilization management.Responsibilities include managing medical denials, handling audit/compliance responsibilities, and resolving charge problems to ensure accurate and complete billing.Key QualificationsActive nursing...

  • Appeals Resolution Professional

    1 week ago

    Manila, National Capital Region, Philippines beBee Careers Full time

    Job Description:Prepare and Submit Clinical Appeals: Write detailed, evidence-backed appeals for denied claims, leveraging clinical evidence, patient records, and the latest medical literature.Analyze Denials: Review denial letters to pinpoint the root causes and strategize effective appeals based on payer-specific requirements and regulatory standards.

  • Clinical Nurse

    4 days ago

    Manila, National Capital Region, Philippines Container Corporation of the Philippines Full time

    Container Corporation of the Philippines is hiring a Full-time Clinical Nurse in Balintawak, NCR. Apply now to join our team.Job summary:Flexible hours available1 year of relevant work experience requiredExpected salary: ₱1,682,375 per monthQualifications and responsibilities:Licensed nurse is an advantage but not requiredCandidate must possess at least a...

  • Clinical Nurse Specialist

    2 weeks ago

    Manila, National Capital Region, Philippines DME Service Solutions Full time

    About DME Service SolutionsWe are a healthcare BPO leader delivering customized workforce solutions that enhance productivity and customer experiences.Our mission is to provide positive customer experiences while achieving strategic business goals. We are driven by our core values of diversity, equity, and inclusion.At DME, innovation and integrity define...

  • Clinical Nurse Data Specialist

    1 week ago

    Manila, National Capital Region, Philippines beBee Careers Full time

    We are seeking a skilled Registered Nurse to collaborate with healthcare providers and members to promote quality member outcomes.About the RoleCollaborate with healthcare providers and members to optimize member benefits and promote effective use of resources.Key ResponsibilitiesPromote quality member outcomes by collaborating with healthcare providers and...

  • Customer Service Representative | 30,000 | Virtual Interview

    2 weeks ago

    Manila, National Capital Region, Philippines Nezda Technologies, Inc. Full time

    We are hiring for the following positions:Healthcare ExecutiveEarn 28k Salary + 20% Night Differential with 25k Signing BonusAt least completed 2 years in College with 1 year healthcare call center experienceCan work on nightshift - Monday to Friday; Weekends OffWilling to work ONSITE - Ortigas, PasigCan start ASAPVirtual ProcessCustomer Service...