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Clinical Nurse Appeals Specialist

1 month ago

Manila, National Capital Region, Philippines Dencom Consultanacy Full time
Job Title: Clinical Nurse Appeals Writer

Job Summary:

We are seeking a skilled Clinical Nurse Appeals Writer to join our team at Dencom Consultancy. As a key member of our appeals team, you will be responsible for writing high-quality appeals for denied claims, utilizing your expertise in MCG/InterQual criteria.

Key Responsibilities:

  • Develop and write comprehensive appeals for denied claims, ensuring accuracy and attention to detail.
  • Collaborate with our team to identify and address potential issues with claims.
  • Stay up-to-date with the latest MCG/InterQual criteria and best practices in appeals writing.
  • Work closely with our clinical team to ensure that appeals are aligned with our clients' needs.

Requirements:

  • PHRN/USRN with at least 3 years of clinical experience.
  • Solid appeals writing experience for denied claims (I/OP).
  • Knowledge of MCG/InterQual criteria.
  • Ability to work onsite and on night shift schedule.

What We Offer:

At Dencom Consultancy, we offer a dynamic and supportive work environment, with opportunities for professional growth and development. If you are a motivated and experienced Clinical Nurse Appeals Writer, we encourage you to apply for this exciting opportunity.