Clinical Appeals Nurse

As 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...

As 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...

As 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...

-Must have PHRN licensed -Must have experienced in clinical appeals / Utilization Management -Research into current healthcare regulations and stipulations—to form the basis for any necessary appeal. Investigation into a patient's history treatment—to better warrant their need for continual care. Reviewing response letters from insurance carriers—and...

Must have PHRN licensedMust have experienced in clinical appeals / Utilization ManagementResearch into current healthcare regulations and stipulations—to form the basis for any necessary appeal. Investigation into a patient's history treatment—to better warrant their need for continual care. Reviewing response letters from insurance carriers—and...

"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

Are you thrilled about delivering outstanding customer service? We're looking for a vibrant PHRN to join our team in Ortigas. Your Key Responsibilities: Assist patients and healthcare providers by delivering exceptional voice support. Provide accurate information and resolve inquiries. Maintain detailed and confidential patient records. Needed...

Are you thrilled about delivering outstanding customer service? We're looking for a vibrant PHRN to join our team in Ortigas. Your Key Responsibilities: Assist patients and healthcare providers by delivering exceptional voice support. Provide accurate information and resolve inquiries. Maintain detailed and confidential patient records. Needed...

The OHN is responsible for promoting and ensuring the health and well-being of JFP employees, clinic management, first aid treatment, and providing professional nursing care to all JFP employees who were injured and sick at work, etc. related to health and safety. Qualifications: Graduate of BS in Nursing. Registered nurse (w/ active PRC License), with...

Responsibilities: Provide Basic Healthcare - The bulk of a company nurse’s day is used providing basic healthcare needs to a company’s employees. This includes administering first aid where needed and evaluating employees’ overall health. Administer Prescribed Medication and Treatment - Some employees may have medication and treatment that needs to be...

Responsibilities:Provide Basic Healthcare - The bulk of a company nurse's day is used providing basic healthcare needs to a company's employees. This includes administering first aid where needed and evaluating employees' overall health.Administer Prescribed Medication and Treatment - Some employees may have medication and treatment that needs to be...

The OHN is responsible for promoting and ensuring the health and well-being of JFP employees, clinic management, first aid treatment, and providing professional nursing care to all JFP employees who were injured and sick at work, etc. related to health and safety. Qualifications: Graduate of BS in Nursing. Registered nurse (w/ active PRC License), with...

The OHN is responsible for promoting and ensuring the health and well-being of JFP employees, clinic management, first aid treatment, and providing professional nursing care to all JFP employees who were injured and sick at work, etc. related to health and safety.Qualifications:Graduate of BS in Nursing.Registered nurse (w/ active PRC License), with...

The 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,...

The 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...

Responsibilities: > Perform screening/identification and assessment of patients in need of case management services. > Expected to integrate key elements and development and coordinate a successful transition to care plan > Provide the following services: education, care coordination, compliance, transition management, utilization...

Responsibilities: - Perform screening/identification and assessment of patients in need of case management services. - Expected to integrate key elements and development and coordinate a successful transition to care plan - Provide the following services: education, care coordination, compliance, transition management, utilization...

Responsibilities: > Perform screening/identification and assessment of patients in need of case management services. > Expected to integrate key elements and development and coordinate a successful transition to care plan > Provide the following services: education, care coordination, compliance, transition management, utilization...

Responsibilities: - Perform screening/identification and assessment of patients in need of case management services. - Expected to integrate key elements and development and coordinate a successful transition to care plan - Provide the following services: education, care coordination, compliance, transition management, utilization...

The 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,...