Current jobs related to Nurse Auditor for Medical Excellence - Manila, National Capital Region - Crawford Group

  • Head Nurse

    3 days ago

    Manila, National Capital Region, Philippines Borough Medical Care Institute Inc. Full time

    About the roleAs the Head Nurse at Borough Medical Care Institute Inc., you will be responsible for overseeing and managing the nursing team to provide excellent patient care in our Pasay City Metro Manila facility. In this full-time role, you will ensure the effective and efficient delivery of nursing services, while promoting a caring and supportive...

  • Senior Nursing Role

    3 days ago

    Manila, National Capital Region, Philippines Borough Medical Care Institute Inc. Full time

    Nursing Management RoleBorough Medical Care Institute Inc. is looking for an experienced Head Nurse to join our team in Pasay City Metro Manila.This leadership role requires a strong clinical background and excellent communication skills.As the Head Nurse, you will oversee the nursing team and ensure the delivery of high-quality patient...

  • Hemodialysis Nurse

    1 week ago

    Manila, National Capital Region, Philippines Cardinal Santos Medical Center Full time

    JOB SUMMARYProvide direct nursing care and assistance to hemodialysis patients. Provide assistance to medical doctors. Assess, develop, and implement, and evaluate a plan of nursing care for patients in an assigned area.QUALIFICATIONSCompletion of a Bachelor's degree in NursingPassed the Nursing Board Licensure examCertification on Hemodialysis, IV Therapy...

  • Nurse Manager Position

    3 days ago

    Manila, National Capital Region, Philippines Borough Medical Care Institute Inc. Full time

    About the RoleWe are seeking a highly skilled and experienced Head Nurse to lead our nursing team at Borough Medical Care Institute Inc. in Pasay City Metro Manila.As the Head Nurse, you will be responsible for overseeing and managing the nursing staff to provide exceptional patient care.You will ensure the effective and efficient delivery of nursing...

  • Medical Coding Specialist

    5 days ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    Theoria Medical is seeking a skilled Medical Coding Specialist to join its team. As a Medical Coding Specialist, you will play a critical role in ensuring compliance with insurance, federal, and state regulations.You will review and analyze medical records and documentation to ensure accurate coding. Assigning appropriate ICD-10, CPT, and HCPCS codes based...

  • Staff Nurse

    1 day ago

    Manila, National Capital Region, Philippines Commonwealth Hospital and Medical Center Full time

    As part of the broader MVP Group of Companies, Commonwealth Hospital and Medical Center (CHMC) is a proud member of the Metro Pacific Health (MPH) group, the hospital network in the Philippines. CHMC is one of the fastest growing members of the MPH group, growing revenue at high double digits in past years to over P1 billion in 2024, and on track to more...

  • Nursing Career Opportunity

    1 day ago

    Manila, National Capital Region, Philippines Commonwealth Hospital and Medical Center Full time

    We are currently seeking a registered nurse to join our healthcare team at Commonwealth Hospital and Medical Center. As a staff nurse, you will play a critical role in delivering high-quality patient care and contributing to the success of our organization.You will be responsible for providing direct patient care, administering medications, and monitoring...

  • Registered Nurse Position

    1 day ago

    Manila, National Capital Region, Philippines Commonwealth Hospital and Medical Center Full time

    As a staff nurse at Commonwealth Hospital and Medical Center, you will have the opportunity to work with a diverse range of patients and contribute to the development of our dynamic healthcare team.We pride ourselves on providing quality patient care, administering medications, monitoring patient progress, and collaborating with the healthcare team to ensure...

  • Nurse

    1 week ago

    Manila, National Capital Region, Philippines MPL Center for Integrative and Functional Medicine Full time

    Registered NurseJoin our team of compassionate healthcare professionalsMpL Center for Integrative & Functional Medicine is seeking a dedicated Registered Nurse to join our dynamic team. As a vital member of our healthcare community, you will play a crucial role in providing exceptional care to our patients.Responsibilities:Assess patient conditions and...

  • Medical Staff Member

    1 day ago

    Manila, National Capital Region, Philippines Commonwealth Hospital and Medical Center Full time

    Commonwealth Hospital and Medical Center is a proud member of the Metro Pacific Health group, one of the fastest-growing networks in the Philippines. We offer a unique opportunity for registered nurses to join our team and contribute to the delivery of exceptional patient care.As a staff nurse, you will be responsible for providing quality patient care,...

  • Nursing Department Supervisor

    3 days ago

    Manila, National Capital Region, Philippines Makati Life Nurture Medical Center Inc. Full time

    As ICU Head Nurse at Makati Life Nurture Medical Center Inc., you will play a vital role in leading our nursing team and ensuring the delivery of exceptional patient care. We are seeking a skilled and experienced nurse leader to fill this critical care leadership position.The ideal candidate will possess a Bachelor's Degree in Nursing (BSN) and at least 5...

  • ICU Head Nurse

    3 days ago

    Manila, National Capital Region, Philippines Makati Life Nurture Medical Center Inc. Full time

    Company DescriptionMakati Life Medical Center is a state-of-the-art healthcare facility in Metro Manila, where patients are the top priority. The hospital is equipped with the finest medical technology, facilities, and doctors to assist everyone's healthcare needs effectively.Job Description:The ICU Head Nurse oversees the nursing staff and ensures the...

  • Medical Coding Professional

    2 days ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    Job Description:We are seeking a detail-oriented and organized Medical Coder to join our team at Theoria Medical. As a Medical Coder, you will play a crucial role in ensuring the accuracy of medical records and billing information.Key Responsibilities:Review and analyze medical records for accurate coding and documentationAssign appropriate ICD-10, CPT, and...

  • Medical Coding Specialist

    2 days ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    Job Summary:Theoria Medical is a leading-edge medical group and technology company seeking a detail-oriented Medical Coding Specialist to join its Quality Department. As a key member of the team, you will play a critical role in ensuring compliance with insurance, federal, and state regulations.About the Role:You will review and analyze medical records and...

  • Medical Coding Specialist

    2 days ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    Job Summary:Theoria Medical seeks a detail-oriented and organized Medical Coding Specialist to support its billing department by accurately reviewing, assigning, and verifying medical codes for various patient services.Key Responsibilities:Review and analyze medical records and documentation to ensure accurate coding.Assign appropriate ICD-10, CPT, and HCPCS...

  • Medical Coding Specialist

    2 days ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. We offer a broad scope of services including multispecialty physician services, telemedicine, remote patient monitoring, and more.As a Certified Medical Coder, you will support...

  • ICU Nursing Director

    3 days ago

    Manila, National Capital Region, Philippines Makati Life Nurture Medical Center Inc. Full time

    At Makati Life Nurture Medical Center Inc., we prioritize patient care and seek a dedicated professional to lead our intensive care unit as ICU Head Nurse. As a key member of our team, you will oversee daily operations, coordinate patient care, and ensure compliance with healthcare regulations.The ideal candidate will possess strong leadership and...

  • Endoscopy Nurse

    3 days ago

    Manila, National Capital Region, Philippines UERM Memorial Medical Center Full time

    JOB DESCRIPTION:Assists in the care of patients undergoing endoscopic and other procedures.Discusses the care plan and discharge instructions for each patient.Records accurate documentation of nursing care provided to patients, ensuring patient confidentiality and integration of information with the health care team.Ensures availability of supplies,...

  • Certified Medical Coder

    1 week ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    Compensation: Php 45,000 - 50,000 (All-in package)Job Location: Remote - PHJob Highlights:Paid Time Off: Relax and recharge with paid vacation and sick leaves.Bonus Boost: Enjoy an extra bonus with our 13th-month pay.Weekends Free: Say goodbye to work on weekends and embrace personal time.Extra Earnings: Overtime opportunities available for additional...

  • Certified Medical Coder

    6 days ago

    Manila, National Capital Region, Philippines Theoria Medical Full time

    1 week ago Be among the first 25 applicantsCompensation: Php 45,000 - 50,000 (All-in package)Job Location: Remote - PHJob Highlights:Paid Time Off: Relax and recharge with paid vacation and sick leaves.Bonus Boost: Enjoy an extra bonus with our 13th-month pay.Weekends Free: Say goodbye to work on weekends and embrace personal time.Extra Earnings: Overtime...

Nurse Auditor for Medical Excellence

2 weeks ago

Manila, National Capital Region, Philippines Crawford Group Full time

We are seeking a Clinical Program Nurse to join our team at Crawford Group. As a key member of our medical billing team, you will be responsible for promoting excellence in medical bill review and process improvement.

About Us

Crawford Group is a leading provider of business solutions, and we are committed to delivering exceptional results for our clients.

Job Description
  • Audit in-patient and/or surgical bills to ensure adherence to standard operating procedures (SOP) and turnaround times.
  • Perform bill review processes using appropriate resources, clarify billing discrepancies, and recommend reimbursement accordingly.
  • Collaborate with peer physicians and provide support to Business Process Associates.
Key Responsibilities
  • Medical Bill Review
    • Process inpatient and/or surgical bills by adhering to SOP and turnaround times.
    • Perform bill review processes using appropriate resources.
    • Clarify billing discrepancies to analyze and recommend reimbursement.
    • Document pertinent information in the system bill notes to support reimbursement determination.
    • Reconsider bills as per request, to ensure original bill processing determination is appropriate.
    • Collaborate objectively with peer physicians to facilitate determination of reimbursement.
  • Business Process Support
    • Provide assistance to Business Process Associates and other departments regarding billing issues and fee schedules.
    • Inform process owners about calculation of reimbursement-related issues.
    • Communicate effectively with case management personnel as needed.
    • Liaise with company attorneys to assist in possible litigated claims.
    • Refer matters beyond authority and expertise to immediate superior for direction.