Clinical Denial Lead
3 weeks ago
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 .
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Clinical Denial Lead
3 weeks ago
National Region, Philippines RSD Human Resource Management Consultancy Full timeThe 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 .
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Clinical Denial Lead
3 weeks ago
National Region, Philippines RSD Human Resource Management Consultancy Full timeThe 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 .
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Clinical Denial QA
3 weeks ago
National Region, Philippines RSD Human Resource Management Consultancy Full timePerforms advanced level work related to clinical denial management. The individual is responsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and others as assigned.
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Clinical Denial QA
3 weeks ago
National Region, Philippines RSD Human Resource Management Consultancy Full timePerforms advanced level work related to clinical denial management. The individual is responsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and others as assigned.
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Clinical Denial Specialist
3 weeks ago
National region, Philippines RSD Human Resource Management Consultancy Full timeThe 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.
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Clinical Denial Specialist
3 weeks ago
National region, Philippines RSD Human Resource Management Consultancy Full timeThe 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.
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Clinic Manager
2 weeks ago
Taguig, Philippines The Aivee Group Full timeI. Job Summary:Oversees the daily administrative operations of a well-functioning clinic facility to ensure implementation of process and procedures to optimize customer service, employee productivity, and increase in revenue. II. Duties & Responsibilities:· Clinic Operations and ManagementØ Oversee the daily operations of the clinic, ensuring...
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Clinical Support Specialist
3 weeks ago
Taguig, Philippines Eviden Full timeShift Schedule: NightshiftWork Setup: HybridSummary:The clinical support specialist (CSS) provides administrative support to clinical staff within Member Health. The CSS adheres to established customer service standards of accuracy, courtesy, and professionalism. This position supports timely determination turnaround times on all prior authorization requests...
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Utilization Review Nurse
3 weeks ago
Philippines Nezda Technologies, Inc. Full timeNezda is currently looking for Utilization Review Nurse (USRN) - WFH candidates.Qualifications: Active USRN and PHRN License With at least 1 Year Clinical or Hospital ExperienceJob Description: Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts. Responsible for conducting...
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Clinical Practice Manager
3 days ago
Philippines, Quezon City Sagility Full timeKey ResponsibilitiesSupport Practice Leader in planning and implementation of the strategic initiatives and long-term goals for the operating groups that the Healthcare Global leadership identifies to be critical to the team's overall strategyLead & generate best practice recommendations for global deployment - Including Training, Technology, Skill...
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Clinical Supervisor
2 weeks ago
Philippines The Medical City Full timeAt The Medical City, we bridge the gap between Filipinos and health services. An ambitious mission, and to achieve it we need the bright minds of our country's young leaders. Young leaders who are willing to inspire a generation and take on the challenges we are faced today. The Medical City seeks to be the home of the world's best when it comes to...
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Clinical Data Analyst
2 weeks ago
Quezon City, Philippines Reed Elsevier Philippines Full timeElsevier is singularly focused on helping healthcare professionals improve clinical outcomes through evidence-based care. Our products and services are designed to help caregivers, professionals, and students improve practice, encourage broad and deep adoption of evidence-based practice, and promote a culture of quality within health care organizations.We...
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Clinical Administrative Assistant
3 weeks ago
Philippines Outsourced Full timeJob SummaryPart Time - Clinical Administrative AssistantJob DescriptionAbout UsOutsourced. Ph is a leading ISO-certified Philippines offshore outsourcing company that provides dedicated remote staff to some of the world's leading international companies. Outsourced is recognized as one of the Best Places to Work and has achieved Great Place to Work...
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Medical Devices Lead Auditor
3 weeks ago
Philippines SGS (Malaysia) Sdn Bhd Full timeJob DescriptionWe have an excellent new opportunity fora Medical Device Lead Auditor to join our global organization.The successful candidate will be responsible for planning and conducting audits against the manufacturing of medical devices, in accordance with ISO 13485, MDD 93/42/EEC, and MDSAP standards, enabling the delivery of assessment and...
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Segment Marketing Lead for Life Science
2 weeks ago
Philippines Monroe Consulting Group Full timeExecutive Search Firm Monroe Consulting Group Philippines is recruiting on behalf of a multinational Medical Device company. Our respected client is seeking a Segment Marketing Lead experienced in life science. S/he will work closely with Regional Segment Leads & Country Leader and play a strategic role in developing impactful marketing strategy that is...
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Segment Marketing Lead for Life Science
2 weeks ago
Philippines Monroe Consulting Group Full timeExecutive Search Firm Monroe Consulting Group Philippines is recruiting on behalf of a multinational Medical Device company. Our respected client is seeking a Segment Marketing Lead experienced in life science. S/he will work closely with Regional Segment Leads & Country Leader and play a strategic role in developing impactful marketing strategy that is...
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Accounts Receivable Specialist
3 weeks ago
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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Associate Marketing Manager
3 weeks ago
Philippines The Medical City Clinic Full timeThe Associate Marketing Manager for Metro Manila Operations is pivotal in providing support to TMC Clinic's Metro Manila operations. This position involves planning, efficient execution, and comprehensive oversight of marketing initiatives, all aimed at promoting TMC Clinic's brand, products, and services within the target market. The primary objectives...
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Mgr Process Improvement
3 days ago
Philippines Carelon Global Solutions Full timeDescription: . Process Improvement and Project Management in a BPO Setup . Six Sigma Certified (Green-Black Belt) . Leadership experience - Should have Experience leading a team in similar Role. . Prioritize to have candidates from Healthcare Account . Experience handling Projects and client Consulting (Cross Functional Projects) . Experience in Clinical...
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USRN Training Specialist
3 weeks ago
Taguig, Philippines Shearwater CPO® - Home of Clinicians Full timeLet your Passion Lead You at the Home of Clinicians with over 4000+ employees who have trusted us with their careers!Our Clinicians and Associate advocates for better patient care while enjoying these benefits:HMO on Day 1 with 2 dependents upon regularizationGroup Life InsuranceHighly Competitive SalaryComplexity AllowanceOnsite AllowanceAnnual Salary...