Clinical Utilization Review Specialist

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...

Job Title: Utilization ReviewerGratitude Philippines is seeking a skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will play a critical role in ensuring that patients receive appropriate and necessary medical care while minimizing costs.Key Responsibilities:Review treatment authorization requests based on state guidelines and...

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...

Job Title: Clinical Review NurseAt Manpower Core Group Inc., we are seeking a highly skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in assessing the medical appropriateness of proposed treatments and medications for our injured employees.Key Responsibilities:Review treatment authorization requests...

Job Title: Utilization ReviewerGratitude Philippines is seeking a highly skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will play a critical role in ensuring that our healthcare services are delivered efficiently and effectively.Key Responsibilities:Conduct thorough reviews of medical records to ensure that healthcare services...

Job Title: Utilization ReviewerGratitude Philippines is seeking a highly skilled Utilization Reviewer to join our team.Key Responsibilities:Conduct thorough reviews of medical records to ensure compliance with workers' compensation laws and regulations.Utilize strong analytical and organizational skills to identify areas for improvement in healthcare...

Job Title: Utilization ReviewerJob Summary: We are seeking a highly skilled Utilization Reviewer to join our team at Gratitude Philippines. As a Utilization Reviewer, you will be responsible for reviewing medical records and ensuring that patients receive the necessary treatments and care. Our ideal candidate will have a Bachelor's degree in nursing, 1-2...

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: BPO Utilization ReviewerSummary:The Clinical Review Nurse position is responsible for assessing the medical appropriateness of proposed treatments and medications for our injured employees. This role partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim, while maintaining a solid understanding of...

Job SummaryThe Clinical Review Nurse position is a critical role in assessing the medical appropriateness of proposed treatments and medications for our injured employees. This position partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim, while maintaining a solid understanding of the Client's mission,...

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...

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...

Job Title: Clinical Appeals SpecialistWe are seeking a highly skilled Clinical Appeals Specialist to join our team at Gratitude Philippines.Key Responsibilities:Review and analyze medical claims to ensure accurate processing and reimbursement.Communicate with healthcare providers and patients to resolve billing discrepancies.Develop and implement strategies...

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 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 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 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...

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 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...