Healthcare Denial Reviewer

Key Responsibilities:Perform advanced level work related to clinical denial and utilization managementManage medical denials by conducting comprehensive reviews of clinical documentationHandle audit/compliance responsibilities and other administrative duties as requiredResolve charge problems to ensure accurate and complete billingThis role requires a...

Access Healthcare 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.Responsibilities:Perform advanced level work related to clinical denial and utilization...

About the JobWe are looking for a Medical Claims Navigator to help us navigate the complexities of medical claim denials. As a Clinical Appeals Specialist, you will be responsible for ensuring fair resolutions for patients and providers.Your Key Responsibilities:Write detailed appeals for denied claimsPartner with physicians, nurses, and other medical...

Job Description:Sourcing Specialists at Access Healthcare Services are responsible for ensuring the timely completion of assigned patient cases.Key responsibilities include performing advanced level work related to clinical denial and utilization management, managing medical denials by conducting comprehensive reviews of clinical documentation, handling...

Job OverviewAn experienced Clinical Appeals Nurse Specialist is required to work with our team at Omega Healthcare Management Services Inc. This role involves analyzing denial of insurance claims, determining the root cause of denials, and composing appeal letters to secure proper reimbursement.Key ResponsibilitiesReview activity summary, documentation, and...

Company Overview:Cognizant Technology Solutions Philippines Inc. is a leading provider of healthcare solutions, dedicated to delivering exceptional patient care and outcomes.Job Summary:We are seeking an experienced Nursing Professional to join our team as a Healthcare Utilization Reviewer. As a key member of our healthcare operations team, you will play a...

Sourcing Specialist at Access Healthcare ServicesAccess Healthcare is looking for a 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, and processing surgery authorizations as needed.Qualifications:Registered Nurse with Active license.BPO...

Role SummaryA Clinical Appeals Nurse Specialist is needed to work with our team at Omega Healthcare Management Services Inc., responsible for reviewing denied insurance claims, identifying the root cause of denials, and composing appeal letters to secure proper reimbursement.Main ResponsibilitiesReview claim and billing history to isolate any denials related...

About the Role:We are seeking a Clinical Operations Specialist to join our team at Access Healthcare Services.As a Clinical Operations Specialist, you will be responsible for managing medical denials, conducting comprehensive reviews of clinical documentation, and handling audit/compliance responsibilities.The ideal candidate will have a strong background in...

**Training and Development**We are seeking a skilled Process Trainer to join our team at Omega Healthcare Management Services Inc. As a Process Trainer, you will play a vital role in educating, guiding, and coaching new employees on how to effectively perform their jobs.Your primary responsibilities will include ensuring that training and assessments happen...

A Clinical Appeals Nurse Specialist is responsible for understanding and analyzing the denials of insurance claims or coverage for medical treatments or procedures at a healthcare facility and determining whether the denial was warranted or whether to move forward with an appeal. An appeal is defined as formal, specific, account-level communication issued to...

Job DescriptionA Clinical Appeals Nurse Specialist is responsible for reviewing denied insurance claims, identifying the root cause of denials, and composing appeal letters to secure proper reimbursement.ResponsibilitiesAccess account from appropriate work queue and mark account worked to ensure it will not be assigned to another reviewer.Review claim and...

We are looking for a detail-oriented Healthcare Claims Processor to join our team in Ortigas CBD, Pasig. As an onsite independent contractor, you will be responsible for preparing and submitting accurate claims to insurance companies.Your key responsibilities will include verifying patient insurance eligibility and benefits, ensuring correct coding, and...

Role OverviewThe position of Medical Claims Analyst is critical in allowing our members, families, facilities, and health professionals to have greater confidence in the exceptional care we provide. As a Medical Claims Analyst, you will be responsible for accounts receivable collections, follow-up, involves denial management, claims payment processing...

Access Healthcare is looking for motivated and detail-oriented individuals to join our Healthcare Prior Authorization team.Key Responsibilities:Review and process prior authorization requests from healthcare providers.Verify patient insurance coverage and ensure compliance with payer requirements.Coordinate with healthcare providers, insurance companies, and...

We are seeking a highly motivated and detail-oriented individual to join our team at Access Healthcare Services Manila, Inc. as a Healthcare Account.About the Role:The successful candidate will be responsible for reviewing and processing prior authorization requests from healthcare providers.This role involves verifying patient insurance coverage and...

About the RoleThis Healthcare Collections Professional position involves working on-site in Alabang, where you will be responsible for collections, follow-up, denial management, claims payment processing, tracking, and status, as well as appeals for hospital processes. Your role is essential in allowing our members, families, facilities, and health...

**Education and Experience**We are seeking a qualified Process Trainer to join our team at Omega Healthcare Management Services Inc. The ideal candidate will have a Bachelor's degree in Nursing with an Active PH Registered Nurse License and experience in a US Healthcare BPO organization.**Responsibilities**Develop and deliver training programs as per client...

Job Overview:The Finance Operations organization provides operations accounting and operations excellence services with the highest level of controllership at Amazon. We work with every part of the company to provide operational processes which completely, accurately, and validly pay suppliers and report financial results.Responsibilities:Contribute to the...

Job Summary:The Healthcare Specialist will be responsible for providing clinical support to healthcare facilities and insurance companies. This includes coordinating preauthorizations, managing documentation, and following up on authorization requests.Key Responsibilities:Coordinating Preauthorizations:• Prepare and submit necessary paperwork and...