Clinical Appeals Nurse – Medical Chart Review Specialist

We are seeking highly qualified professionals to join our team as Clinical Appeals Specialists (PHRNs). This role offers competitive compensation, bonuses, and the opportunity to work onsite in Quezon City.Role SummaryWe are looking to hire 10 Clinical Appeals Specialists (PHRNs) with an onboarding date of September 2, 2025. Candidates must complete all...

Transforming health outcomes requires a dedicated professional who can deliver clinical support for performing in-depth reviews of appeals. This role also involves reviewing quality of service issues, ensuring compliance with state and federally mandated turn-around-times and process requirements.Deliver high-quality clinical support for the review of...

**What we offer: Salary Package: PHP 50,000**Sign-On Bonus: PHP 50,000Work Setup: Onsite at Bridgetowne, Quezon CitySchedule: Shifting Schedule Required Qualifications:An active Philippine Registered Nurse (PHRN) license is required.At least 1 year of clinical nursing experience (hospital, clinic, or managed care setting).A minimum of 6 months of Clinical...

Job Overview:We are seeking a highly skilled Registered Nurse to provide clinical support for performing thorough reviews of appeals and quality of service issues.Key Responsibilities:Analyzing, reviewing and evaluating appeals in compliance with state and federally mandated timelines and process requirementsComplying with employment contract terms,...

ECLARO is currently hiring Clinical Appeals Specialists (PHRN) for our BPO client in Bridgetowne.If you're interested, please send your resume toQualifications:Must be an active PHRN license holderAt least 1 year of clinical experience (hospital, clinic, or managed care setting)Minimum of 6 months of clinical process outsourcing experience, with strong...

Healthcare SpecialistWe are seeking a qualified professional to fill a clinical review and adjudication role. The ideal candidate will have experience in clinical review, excellent verbal and written communication skills, and be able to work independently with minimal supervision.Clinical Review Nurses – Conduct clinical reviews of cases not meeting...

Job Title:PHRN Roles - Virtual ProcessJob Description:Clinical Appeals Nurses work with patients' medical charts and records to determine if they require admission, observation, or hospital care. They review lab work and make informed decisions about patient care.Key Responsibilities:Review patients' medical charts and recordsDetermine appropriate patient...

Job DescriptionWe are seeking a highly skilled and detail-oriented clinical professional to support our residential, PHP, and IOP levels of care. This individual will be responsible for conducting peer reviews, case consultations, and interfacing with insurance payers to obtain continued authorization.The ideal candidate will be a licensed clinician who is...

Job SummaryClinical Appeal Specialist role available in a dynamic BPO setting.Key ResponsibilitiesAssist with medical necessity reviews and interpretation of clinical documentation.Collaborate with cross-functional teams to ensure accurate and timely appeal resolutions.RequirementsActive PHRN license holder required.Minimum 1 year of clinical experience in...

Job Title: Healthcare Content SpecialistOverview of the PositionThe Healthcare Content Specialist occupies a pivotal role within our organization, working on an automated claims editing solution utilized by medical insurance payers across the United States.Responsibilities and Key TasksConduct in-depth research to identify Medicare, Medicaid, and other...