Clinical Appeals Specialist

Role Summary: We are seeking a skilled RN Clinical Specialist to join our team at Gratitude Philippines. In this role, you will be responsible for handling clinical appeals and denials for healthcare insurance claims.Key Responsibilities:Review and evaluate clinical appeals and denials for healthcare insurance claimsUtilize clinical expertise to make...

Clinical Opportunities at Gratitude Philippines**Job Summary**We are seeking a skilled Clinical Appeals Specialist to join our team. The ideal candidate will have a strong background in utilization management review or clinical appeals and denials handling for healthcare insurance/UMR.**Key Responsibilities**- Conduct thorough reviews of medical claims to...

Job SummaryWe are seeking an experienced Advanced Clinical Nurse Specialist to join our team at Gratitude Philippines. In this role, you will utilize your expertise in utilization management review and clinical appeals and denials handling for healthcare insurance/ UMRS.About the RoleThis is a full-time position that requires flexible shifts, with a...

Job Title: Clinical Utilization SpecialistGratitude Philippines is seeking a highly skilled Clinical Utilization Specialist to join our team. As a key member of our healthcare team, you will play a vital role in ensuring the highest quality of care for our patients.Key Responsibilities:Conduct thorough reviews of patient cases to ensure medical necessity and...

We are seeking a skilled Clinical Care Specialist to join our team at Megaworld Corporation. This is a Full-time position that requires a Registered Nurse with a strong background in patient care and clinical skills.The ideal candidate will have at least 1 year of experience in nursing and be proficient in MS Office. The following skills are...

Job Title: Clinical Coding SpecialistAbout the Role:We are seeking a skilled Clinical Coding Specialist to join our team at TASQ Staffing Solutions.Key Responsibilities:The successful candidate will be responsible for performing accurate and timely coding of patient records, ensuring compliance with industry standards and regulations.Requirements:To be...

Job Title: Clinical Excellence SpecialistJob Summary:We are seeking a Clinical Excellence Specialist to join our team at Gratitude Philippines. The successful candidate will be responsible for carrying out quality assurance oversight activities, conducting regular reviews of managed care internal and external claim files, and analyzing quality assurance...

Job SummaryWe are seeking a highly skilled Clinical Support Specialist to join our team at MetaHealth. As a key member of our healthcare team, you will play a vital role in ensuring the highest level of patient care and satisfaction.ResponsibilitiesProvide top-notch support to clients, ensuring their needs are met and exceeded.Utilize your analytical skills...

Job Title: Clinical Utilization Review SpecialistGratitude Philippines is seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our healthcare team, you will play a critical role in ensuring that our clients receive the most appropriate and cost-effective care.Key Responsibilities:Review treatment authorization...

Job Title: Clinical Nurse Specialist - Accidental ClaimsAbout the Role: We are seeking a highly skilled Clinical Nurse Specialist to join our team at TASQ Staffing Solutions. As a key member of our staff, you will be responsible for handling accidental claims with exceptional attention to detail and organizational skills.Job Responsibilities: Your primary...

Job SummaryMetaHealth is seeking a skilled Clinical Support Specialist to join our team. As a Clinical Support Specialist, you will be responsible for providing top-notch support to our clients. Your analytical skills will be utilized to troubleshoot and resolve issues, ensuring a positive impact on client satisfaction.ResponsibilitiesProvide clinical...

At RecruiterPH, we are seeking a Quality Assurance Specialist to join our team. In this role, you will be responsible for ensuring that project-related quality processes are followed by associates and delivering required numbers of QA Monitors on a timely manner.About the RoleThe ideal candidate will have at least 1-2 years of QA experience in a BPO setup...

We are RecruiterPH, a leading recruitment agency in the Philippines, and we are seeking a highly skilled Trainer/Training Specialist to join our team. As a Trainer/Training Specialist, you will play a critical role in ensuring that our trainees receive high-quality training and assessments.About the RoleThe ideal candidate will have a graduate/postgraduate...

OverviewThe Manpower Core Group Inc. seeks a skilled Clinical Telephonic Nurse Specialist to provide exceptional patient care and support via telephone assessments, health advice, and referrals.Key Responsibilities:Performing intake of phone calls from injured employees to provide timely and effective assistance.Conducting telephonic health assessments,...

OverviewGratitude Philippines is a reputable healthcare organization seeking a skilled Clinical Utilization Specialist to join our team. This role plays a crucial part in ensuring the efficient use of medical resources and promoting high-quality patient care.

Job Title: Clinical Utilization Review SpecialistAbout the Role:Gratitude Philippines is seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our Utilization Review team, you will be responsible for reviewing treatment authorization requests based on state guidelines and medical necessity.Key...

Tasq Staffing Solutions is hiring a Inpatient Medical Coder to join our team. This role is perfect for individuals with experience in clinical, BPO, or CPO set-ups who are passionate about medical coding and have excellent communication skills.The ideal candidate will possess a Bachelor's degree in Nursing or a related field and be certified as a Certified...

Job SummaryWe are seeking a highly skilled and experienced RN to join our team at Gratitude Philippines. The ideal candidate will have a strong background in utilization management review and clinical appeals and denials handling for healthcare insurance.Key ResponsibilitiesConduct thorough reviews of medical records to determine the appropriateness of...

Job Purpose:As a Quality Assurance Specialist at RecruiterPH, you will be responsible for ensuring that project-related quality processes are followed by associates. This includes tracking and trending data for improvement, providing coaching to employees, and analyzing client-specific metrics and internal metrics. You will also participate in call...

Job Title: PHRN OHNJob Summary:We are seeking a highly skilled and motivated PHRN OHN to join our team at MetaHealth. As a key member of our healthcare team, you will be responsible for providing top-notch support to our clients.Key Responsibilities:Use your analytical skills to troubleshoot and resolve issuesMake a positive impact on client...