Clinical Appeals Professional

About the RoleIn this critical position, you will work closely with our team to provide exceptional customer support, manage complex appeals and grievances, and ensure high-quality outcomes. Your strong analytical and problem-solving skills will enable you to navigate intricate cases and make informed decisions.This is an excellent opportunity to utilize...

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...

Access Healthcare Services Manila, Inc. is looking for a skilled Registered Nurse to assume a critical role in our team.The ideal candidate will be responsible for ensuring the completion of assigned patient cases by performing advanced level work related to clinical denial and utilization management.Key Responsibilities:Manage medical denials by conducting...

Access Healthcare Services Manila, Inc. is a leading healthcare provider seeking a skilled Registered Nurse to assume a critical role in our team.The successful candidate will be responsible for managing medical denials by conducting comprehensive reviews of clinical documentation.Key Responsibilities:Handle audit and compliance responsibilities.Write...

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...

We are currently seeking a Clinical Analyst to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The Clinical Analyst is responsible for analyzing, interpreting, and assigning the correct codes for the descriptions available on various medical procedures and diagnoses, as well as other related medical...

We are seeking a talented and compassionate Clinical Support Professional to join our team at Megaworld Corporation.Your key responsibilities will include:Providing medical assistance and support to employees;Assessing employee health status and identifying potential risks;Developing and implementing health promotion programs.Qualifications and...

We are seeking a highly skilled Clinical Educator to join our team at Conexus MedStaff. In this role, you will be responsible for designing and delivering high-quality clinical education programs for our clients' healthcare teams.Responsibilities:Develop and implement clinical training programsEvaluate healthcare professionals' skills and...

At Omega Healthcare Management Services Inc., we are seeking an experienced Registered Nurse (RN) to join our team.Job OverviewThis is a unique opportunity for a skilled RN to leverage their clinical expertise in bedside care, preferably in Med-Surg, ICU, or ED settings. The ideal candidate will have a strong understanding of clinical validation for DRG...

As a Clinical Documentation Specialist at Stark Asia Solutions Inc., you will play a vital role in ensuring the accuracy, completeness, and compliance of clinical documentation within healthcare organizations. Your responsibilities will include conducting systematic reviews of medical records, billing codes, and clinical procedures to verify adherence to...

Welcome to ActiveOne Health!We're a dynamic team looking for an experienced Occupational Health Nurse to join our On-Site Clinic Management Team.Your responsibilities will include providing expert care to employees, maintaining accurate records, and managing our medicine and supply inventory.About the Role:As a Company Nurse / OH Nurse, you'll work closely...

About the RoleAs a Clinical Specialist at Transmedic Philippines, Inc., you will be responsible for delivering exceptional customer service and technical support for our medical products. Your primary focus will be on ensuring the successful installation, operation, and maintenance of our medical equipment.Key AccountabilitiesTo provide expert clinical...

At Calderon Medical Clinic, we are committed to providing exceptional patient care and promoting overall wellness. We are seeking a dedicated and compassionate Registered Nurse to join our team and contribute to our mission.Role and ResponsibilitiesThis role involves working closely with our doctor and other healthcare professionals to provide direct patient...

About This PositionWe seek a dedicated Clinical Appeals Coordinator to join our team at UST. As a key member, you will play a vital role in providing exceptional customer support, managing complex appeals and grievances, and ensuring high-quality outcomes.Your responsibilities will include investigating and processing appeals, reviewing services for medical...

ResponsibilitiesThis role entails investigating and processing complex appeals and grievances, reviewing services for medical necessity, preparing documentation, and collaborating with the Medical Director.You will also be responsible for documenting and logging appeal/grievance information, generating written correspondence, and serving as a subject matter...

Experience and Specifications:Graduate of any medical related degree – License is not requiredMinimum of 3-year related experience in identifying, coordinating and determining Medicare and other insurance coverage. Related experience on recovery opportunities in cases where TPL/COB exists and/or provider overpayments based on standard policies, procedures...

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...

**Join Our Team:**Avignon Clinic is a dynamic and growing organization, dedicated to providing world-class aesthetic services and exceptional patient care. We are seeking a talented Aesthetic Nurse to join our team and contribute to our success.**Key Responsibilities:**Work closely with doctors to deliver high-quality treatmentsMaintain all equipment in good...

Mental Health Professional NeededWe are seeking a highly skilled Psychotherapist / Psychologist to join our team of mental health professionals. As a part-time therapist, you will work with clients with various mental health needs.About the JobYou will provide counseling services to adults who have completed online screenings identifying their symptoms and...

Fatima University Medical Center, a premier healthcare institution, is dedicated to providing exceptional patient care and fostering medical innovation. Our team of experts is committed to enhancing health and wellness in our community.We are seeking a highly skilled Clinical Pharmacist to contribute to our mission. The ideal candidate will have a Diploma in...