Healthcare Case Manager
2 days ago
At Access Healthcare Services Manila, Inc., we are committed to delivering high-quality healthcare services to our patients.
We are currently seeking a skilled Registered Nurse to assume a key role in our team.
Job Summary:
- Perform advanced level work related to clinical denial and utilization management.
- Manage medical denials by reviewing clinical documentation.
- Handle audit and compliance responsibilities.
Responsibilities:
- Ensure the completion of assigned patient cases.
- Write compelling arguments and submit appeals.
- Actively manage denial or appeal activity.
- Report emerging trends related to payer denials.
Qualifications:
- A registered nurse with an active license.
- 1-3 years of experience in a hospital bedside/acute care/clinical setting.
- Strong communication and analytical skills.
We are seeking a dedicated and detail-oriented individual to join our team.
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