Virtual Process Clinical Appeal Nurse

Job OverviewWe are seeking a skilled Clinical Appeals Nurse to assess patients' medical charts and determine the most suitable level of care.Key Responsibilities:Review patients' medical records, lab results, and medical chartsDetermine whether patients require hospital admission, observation, or no hospital care at allRequirements:At least two years'...

Clinical Appeals Nurse OpportunityJob DescriptionWe seek a skilled Clinical Appeals Nurse to review medical charts and records, determining appropriate care for patients. This role involves thorough analysis and decision-making to ensure accurate assessments.Required Skills & QualificationsAt least 2 years of experience in adult Medical Surgical...

Join to apply for the GRRI: Clinic Nurse - Cavite & Lemery, Batangas Areas role at ACTIVEONE HEALTH, INC.6 days ago Be among the first 25 applicants Locations:Silang, Cavite: G/F Premier Plaza E. Aguinaldo Highway, Bgy. Lucsuhin, Silang, CaviteKawit, Cavite: G/F Units 10 & 11 Robertsons Plaza, Centennial Rd., Kawit, CaviteImus, Cavite: G/F CityMall Anabu...

Job DetailsWe are seeking a skilled Registered Nurse (USRN) to join our team.ResponsibilitiesProvide high-quality patient care, adhering to URAC standards and client requirements.Conduct thorough reviews of Workers Compensation Utilization Management services for Inpatient/Outpatient services.Perform Healthcare Utilization Management Provider Appeals reviews...

Clinical Nurse Case Manager OpportunityWe are seeking a skilled Clinical Nurse Case Manager to join our team. In this role, you will be responsible for conducting medical management reviews to ensure members have access to necessary healthcare services.This position is ideal for nurses who enjoy working in a dynamic environment and have strong critical...

Perform nursing care and procedures such as vital signs monitoring, IV insertion, pre- and post-operative care, and physical examinations.Assist physicians in diagnostic and outpatient procedures while ensuring patient comfort.Implement doctor's orders in compliance with medical policies and legal standards.Maintain accurate documentation of procedures,...

The Role of a Remote Clinical AssistantWe are seeking an experienced and skilled Remote Clinical Assistant to join our team. This role is responsible for providing direct support to the Director of Nursing in overseeing clinical operations for home care services.Job Description:Review and maintain patient care plans, MARs, and physician orders to ensure...

ResponsibilitiesWill assist directly assigned HRD personnel in collaboration on needed documents related to HMO.Will assist directly assigned HRD personnel in terms of needed documents for PhilHealth and SSS benefit application on sickness, maternity, and Magna Carta, EC claims.The Company will provide transportation in case the Nurse may be required to...

Job Title: Registered Nurse – Quality Assurance (QA) ReviewerLocation: Remote (Must work Central Time hours)Hours: Full-time, 37.5 hours/weekPay: $4- $5/hrStart Date: ASAPAbout the Role:We are seeking a detail-oriented and fast-reading Registered Nurse to support our team by reviewing clinical documentation and timesheets for accuracy and quality. This...

Clinical Data Specialist RoleWe are seeking a detail-oriented Registered Nurse with strong clinical judgment to join our team.Key Responsibilities:Data Validation & ReviewManually review patient records post-migration to ensure accuracy and completeness.Compare data fields in the new EHR against the legacy source, identifying discrepancies.Quality...