Medical Review Specialist

Medical Review Nurse JobWe are seeking a skilled Medical Review Nurse to join our team. As a Medical Review Nurse, you will play a critical role in reviewing patient medical records and making recommendations for optimal care.This position requires strong clinical skills and the ability to work independently. The ideal candidate will have a Bachelor's degree...

Job DescriptionLacson & Lacson Insurance Brokers, Inc. is seeking a highly skilled Medical Claims Specialist to join our team.About the RoleThe successful candidate will be responsible for reviewing medical claims from employees, endorsing employees for inclusion and exclusion, and assisting in the roll-out of wellness and other related programs.Key...

Roles and Responsibilities:• PH Nurses to review treatment authorization request based on state guidelines and medical necessity and take decision to approve/deny. In case of denial send this to independent panel review to support the decision. Nurses will work with Claims adjuster on denial decision based on risk tolerance to ensure the denial doesn't...

Responsibilities:-Review inpatient medical records to ensure accurate ICD-10-CM, ICD-10-PCS, and DRG coding.-Collaborate with physicians, nurses, and clinical teams to improve documentation quality and completeness.-Conduct clinical documentation reviews to ensure compliance with CMS, AHIMA, and ACDIS guidelines.-Identify documentation discrepancies and...

Summary:The Clinical Review Nurse position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim. Maintains a solid understanding of Client's mission, vision, and values. Upholds the standards of the...

Summary:The Clinical Review Nurse position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim. Maintains a solid understanding of Client's mission, vision, and values. Upholds the standards of the...

Accounting and Finance ResponsibilitiesWe are seeking a seasoned Financial Specialist to join our team at Fresenius Medical Care. The successful candidate will be responsible for various accounting and finance tasks, including:Managing financial transactions, ensuring accuracy and compliance with regulatory requirements.Maintaining balance sheet...

Required Qualifications:• Bachelor's degree in nursing (BSN)• Active unrestricted RN license that can be validated thru PRC website• 1-2 years of relevant Clinical experience in any medical/surgical department, Orthopedic, Medical/Surgical ICU, Coronary Care Unit (CCU), Rehabilitation, Emergency department• Written and verbal fluency in English•...

Job DescriptionFresenius Medical Care seeks a highly skilled Financial Specialist to join our team. The successful candidate will be responsible for managing financial transactions, ensuring accuracy and timeliness, and complying with regulatory requirements.This involves:Recording transactions in the general ledger, adhering to customer requirements and...

Discover your 100% YOU with usPosition: Medical Content AnalystLocation: BGC, Taguig CityWork Set-up & Shift: Work From HomePosition Summary:The Medical Content Analyst will be responsible in conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content)...

Responsibilities:-Review inpatient medical records and documentation to assign accurate ICD-10-CM, ICD-10-PCS, and DRG codes.-Ensure compliance with CMS (Centers for Medicare & Medicaid Services), AHIMA, and AAPC coding guidelines.-Validate physician documentation to support assigned codes and query providers when necessary.-Work closely with billing,...

You're an important part of our future. Hopefully, we're also a part of your future At B. Braun, we protect and improve the health of people worldwide. You support this vision, bringing expertise and sharing innovation, efficiency and sustainability as values. That's why we would like to keep developing our company with you. Keeping your future in mind,...

Discover your 100% YOU with usPosition: Medical Content AnalystLocation: BGC, Taguig CityWork Set-up & Shift: Work From HomePosition Summary:The Medical Content Analyst will be responsible in conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content)...

Requirements:Bachelor's degree in Nursing or Medical-related courseWith recent medical coding experience in clinical/BPO/CPO set-upWith active Certified Coding Specialist (CCS) or Certified Documentation Integrity Practitioner (CDIP)Experience CDI Specialist is also welcome to applyExcellent communication, organizational, time management, and interpersonal...

The Medical Historian is responsible for interviewing patients, retrieving and reviewing information to compose accurate and complete medical records.Job DescriptionMakes the initial call to the patient to schedule the interview.Retrieves the source documents and reviews the information to get the medical background of the Patient.Calls the Patient on the...

About the RoleMedtronic is seeking a Medical Device Regulatory Compliance Specialist to join our team. The successful candidate will have at least 2 years of experience in the medical device industry or a similar environment, with a good understanding of GDP and ISO 13485 implementation.In this role, you will be responsible for ensuring that our medical...

Job SummaryTenet Global Business Center, Inc. is looking for a skilled Clinical Data Abstractor to support our quality initiatives by collecting and analyzing clinical data from patient records.ResponsibilitiesGather relevant data elements from EMRs and enter them into a computer database or registry site, adhering to established guidelines.Conduct thorough...

Requirements:Bachelor's degree in Nursing or Medical-related courseWith recent medical coding experience in clinical/BPO/CPO set-upWith active Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) licenseExcellent communication, organizational, time management, and interpersonal skillsOnsite

Company Overview">Fresenius Medical Care is a leading healthcare company dedicated to improving the lives of patients worldwide.">Job Summary">We are seeking an ATR Financial Specialist to join our team in Manila. The successful candidate will be responsible for providing timely and accurate recording of transactions in the general ledger, ensuring...

Job Title: Medical Receptionist Location: BGC, Taguig City (Ground Floor, The Spa, B8, 9th Ave, Taguig, Metro Manila)Company: Next Health Diagnostics About Us:At Next Health Diagnostics, we believe in the power of proactive healthcare – a paradigm shift from reactive medicine to a future where individuals are empowered with knowledge and tools to take...