Denials Process Consultant 3 yrs of experience in Denial Managemt

4 weeks ago


manila, Philippines BPO-services Full time

Denials Process Consultant

***At least 3 years of experience in Denial Management
• 5+ years of experience working with RCM hospitals and operations or clinical professionals
• 5+ years of experience analyzing large data sets to identify trends, develop baselines, and track improvement
• 5+ years of experience creating presentations demonstrating outcomes and presenting in-person or remotely to executive audiences
• 3+ years of experience in Healthcare Revenue Cycle including Denials Management and Payor Appeals
• 3+ years of experience working with Patient Financial Services, Business Office, Insurance claim billing, Collections, Reimbursement, Patient Access, Coding
• 3+ years of experience in denial prevention operations and/or process improvement methodologies

PHP 115,000 - PHP 150,000 Basic Salary + PHP 3,600 Allowance

QC, Makati, Muntinlupa
Night Shift; Weekends Off; Hybrid; Follows US Holidays



  • Manila, Philippines BPO-services Full time

    Denials Process Consultant***At least 3 years of experience in Denial Management• 5+ years of experience working with RCM hospitals and operations or clinical professionals• 5+ years of experience analyzing large data sets to identify trends, develop baselines, and track improvement • 5+ years of experience creating presentations demonstrating outcomes...


  • manila, Philippines BPO-services Full time

    Denials Process Consultant ***At least 3 years of experience in Denial Management • 5+ years of experience working with RCM hospitals and operations or clinical professionals • 5+ years of experience analyzing large data sets to identify trends, develop baselines, and track improvement • 5+ years of experience creating presentations demonstrating...


  • Manila, National Capital Region, Philippines BPO-services Full time

    Denials Process ConsultantRequirements: At least 3 years of experience in Denial Management 5+ years of experience working with RCM hospitals and operations or clinical professionals 5+ years of experience analyzing large data sets to identify trends, develop baselines, and track improvement 5+ years of experience creating presentations demonstrating...


  • Manila, National Capital Region, Philippines BPO-services Full time

    Denials Process ConsultantMinimum 3 years of experience in Denial Management 5+ years of experience collaborating with RCM hospitals and operations or clinical professionals 5+ years of experience analyzing substantial data sets to detect patterns, establish baselines, and monitor progress 5+ years of experience crafting presentations showcasing results and...

  • Clinical Denial Lead

    2 weeks ago


    Manila, National Capital Region, Philippines RSD Human Resource Management Consultancy Full time

    The Clinical Denial Specialist conducts comprehensive reviews of the claim denial, account/guarantor notes associated with the denial, and the medical record to make determinations if a revised claim needs to be submitted, if a retro authorization needs to be obtained, if a written appeal is needed, or if no action is .


  • Manila, National Capital Region, Philippines Tenet Global Business Center, Inc. Full time

    JOB SUMMARYResponsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIESValidate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons....


  • Metro Manila, Philippines Tenet Global Business Center, Inc. Full time

    JOB SUMMARYResponsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIESValidate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons....


  • Metro Manila, Philippines Tenet Global Business Center, Inc. Full time

    SUMMARYThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on industry-accepted criteria. He / She is also relied on when it comes to...


  • Manila, National Capital Region, Philippines Tenet Global Business Center, Inc. Full time

    SUMMARYThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on industry-accepted criteria. He / She is also relied on when it comes to...


  • Manila, National Capital Region, Philippines RSD Human Resource Management Consultancy Full time

    The Clinical Denial Specialist writes and submits professionally written appeals which include compelling arguments based on clinical documentation, third-party payer medical policies, and contract language. Appeals are submitted timely and tracked through final outcome.


  • Metro Manila, Philippines Access Healthcare Services Manila, Inc. Full time

    Accesshealthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Qualifications :Must be Registered Nurse with Active licenseHospital Bedside experience (OR /ER / ICU/...

  • Hiring for PHRN

    2 weeks ago


    Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Accesshealthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Qualifications :Must be Registered Nurse with Active licenseHospital Bedside experience (OR /ER / ICU/...


  • Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Accesshealthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Qualifications : Must be Registered Nurse with Active licenseHospital Bedside experience (OR /ER / ICU/...


  • Manila, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    Accesshealthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Qualifications : Must be Registered Nurse with Active licenseHospital Bedside experience (OR /ER / ICU/...


  • Manila, National Capital Region, Philippines R.B Consultant Full time

    Posted: 3 days ago Openings: 50 Applicants: 19 Req-UK Travel Sales executive (noida)Exp. minimum 1 year in International Sales Process (UK/US process)Exp: of GDS/Amadeus/Galileo and inbound sales processMin.1 Yr Exp.50k + TARotational ShiftCo- Swati Skills highlighted with '' are preferred keyskills Req-UK Travel Sales executive (noida)Exp. minimum 1...


  • Metro Manila, Philippines Access Healthcare Services Manila, Inc. Full time

    Accesshealthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Qualifications : Must be Registered Nurse with Active licenseHospital Bedside experience (OR /ER / ICU/...


  • Manila, National Capital Region, Philippines R.B Consultant Full time

    Posted: 10 days ago Openings: 10 Applicants: 103 Req.US Travel Sales ConsultantMin.1 Yr Exp.Must In Google Campaign callUS Flight ReservationNoida Sec 62Salary-50k+ Smart incentivesRotational ShiftsRotational OffTAC/o swati Skills highlighted with '' are preferred keyskills Req.US Travel Sales ConsultantMin.1 Yr Exp.Must In Google Campaign callUS Flight...


  • Manila, National Capital Region, Philippines CorroHealth Full time

    Dear Candidates,Greetings from Corrohealth Immediate Openings for EM IP OP Coder Specialty: EM IP & OP , EM With Surgery, Emergency Department-Facility ,ProfessionalLocation: Noida 142 SecExperience: Min 1yrs - Max6yrsInterview Process: Virtual (MS Teams)Certification: CPC, CCS, COC, CIC AAPC/AHIMA is MandatoryNotice Period: Immediate to 30 daysJob...


  • Manila, Philippines Visaya KPO Full time

    Job Summary: This position performs audits of medical records on behalf of hospital clients for denial review, disallowed charges, and utilization reviews. This position requires critical thinking and judgment and must demonstrate the ability to appropriately use standard criteria such as InterQual and MCG in addition to criteria established by state...


  • Manila, Philippines Med Supply US Full time ₱25,000 - ₱30,000

    Medical Prior Authorization-Insurance Verification SpecialistPosition Summary:The Prior Authorization Specialist plays a crucial role in the healthcare industry by ensuring that medical services, procedures, and medications are approved by insurance companies or third-party payers before they are rendered or prescribed. They work closely with healthcare...