Healthcare Denial Specialist

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...

ObjectiveTo secure proper reimbursement for denied insurance claims by analyzing the root cause of denials and composing effective appeal letters.Main TasksReview activity summary, documentation, and correspondence to obtain notes related to the denial.Work on Medical Necessity and No Authorization denials, and Untimely filing only.Compose appeal letter if...

Job DescriptionIn this role, you will be responsible for monitoring and following up on unpaid or denied insurance claims to ensure timely reimbursement. You will also identify reasons for claim denials, prepare and submit appeals, and work towards resolving issues to minimize revenue loss.Responsibilities:Claims Follow-Up: Monitor and follow up on unpaid or...

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...

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...

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...

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...

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...

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...

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...

Job OverviewThe Finance Operations organization plays a vital role in providing operations accounting and operations excellence services to various parts of Amazon, with a focus on delivering high-quality financial results at the lowest possible cost. As part of the Amazon Healthcare Global Finance Operations Services team, you will collaborate with...

As a Registered Nurse with Access Healthcare Services Manila, Inc., you 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 reviewing clinical documentation.Handle audit and compliance...

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...

About the RoleWe are seeking a skilled Clinical Authorization Specialist to join our team at Omega Healthcare Management Services Inc.This role is ideal for individuals with a passion for delivering exceptional patient care and a strong understanding of healthcare regulations.

Required Skills and QualificationsTo excel in this role, applicants should possess the following skills and qualifications:Previous experience in Hospital/Facility or Physician billing.At least 1 year experience in handling inbound calls for a healthcare account.Familiarity with basic healthcare claims and denials, as well as EOBs.Experience with GE...

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...

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...

Seniority Level and Employment TypeThis is an executive-level position, and the successful candidate will be employed on a full-time basis.The ideal candidate will have a strong understanding of the healthcare industry and excellent leadership and communication skills. Previous experience in channel sales and sales management is also essential.Industry and...

About the RoleThe Revenue Cycle Management Specialist will be responsible for overseeing the end-to-end revenue cycle process, ensuring accurate, timely, and compliant billing and collection activities. This role plays a key part in optimizing revenue cycles and supporting healthcare providers in maximizing reimbursement, minimizing denials, and reducing...