permanent remote job- home health pre claim/adr reviewers

2 weeks ago

Work from Home, Philippines Cliniqon LLC Full time ₱350,000 - ₱700,000 per year

Are you detail-oriented and passionate about ensuring accuracy and compliance in healthcare documentation? We're looking for a dedicated Home Health Pre-Claim / ADR Reviewer to join our team, helping us deliver excellence in patient care and reimbursement processes.

As a Home Health Pre-Claim / ADR Reviewer, you will play a critical role in reviewing and processing pre-claim submissions and Additional Documentation Requests (ADRs). Your meticulous attention to clinical documentation and thorough knowledge of Medicare, Medicaid, and other payer requirements will ensure claims are accurate, complete, and compliant—supporting timely reimbursement and high-quality care delivery.

You will collaborate closely with clinical staff, stay ahead of regulatory updates, and help improve documentation standards across the board.

Responsibilities

  • Review pre-claim submissions for completeness and adherence to payer requirements.
  • Ensure clinical documentation accurately reflects patient conditions and care provided.
  • Provide clear, constructive feedback to clinical teams on documentation improvements.
  • Analyze ADRs to identify and gather necessary documentation for compliance.
  • Submit timely, accurate ADR responses to avoid reimbursement delays.
  • Stay informed of evolving home health regulations and payer policies.
  • Conduct regular audits to maintain compliance and quality standards.
  • Participate in ongoing training to enhance your regulatory and compliance expertise.
  • Collaborate effectively with clinical and billing teams to resolve documentation or claims issues.
  • Report regularly to management on pre-claim and ADR review status and trends.

Requirements:

  • Bachelor's degree in Nursing, Health Information Management, or a related field preferred.
  • Minimum 1 year experience in home health care, with a focus on documentation and compliance.
  • Solid knowledge of Medicare and Medicaid home health regulations.
  • Prior experience in pre-claim review or ADR processing is a strong plus.
  • Exceptional attention to detail and strong organizational skills.
  • Ability to interpret complex regulatory requirements accurately.
  • Proficiency with Electronic Health Records (EHR) and clinical documentation systems.
  • Excellent communication and interpersonal skills to work effectively with multidisciplinary teams.

Why Cliniqon?

  • Permanent work-from-home
  • Retention bonus
  • Performance bonus
  • Immense growth opportunities
  • Company-provided assets
  • HMO coverage
  • Many more benefits

Apply Now

Send your resume to

Ready to make an impact in home health care? Apply now and join a company that values your expertise and supports your professional growth

Job Type: Full-time

Benefits:

  • Health insurance
  • Life insurance
  • Opportunities for promotion
  • Paid training
  • Pay raise
  • Work from home

Application Question(s):

  • Do you have at least one year of experience in home health care documentation and compliance?
  • Are you familiar with Medicare and Medicaid regulations related to home health services?
  • Have you previously worked in a pre-claim review or Additional Documentation Request (ADR) processing role?
  • Are you proficient in using Electronic Health Records (EHR) systems?
  • Are you amenable to start ASAP?

Work Location: Remote

  • pre claim adr/rcd reviewers

    1 week ago

    Work from Home, Philippines Cliniqon Full time ₱450,000 - ₱600,000 per year

    We're Hiring: ADR/RCD Reviewers at CliniqonJob location – Remote/ Permanent WFHShift timing – Night ShiftJOB DESCRIPTION:In this role, you will be required to:Review the quick assessment form from ground nurses and transcribing into EMRPerforms RCD and ADR review for Home Health and HospiceGather, reviewer, and compile all necessary clinical...

  • permanent remote job- home health clinical intake coordinators

    2 weeks ago

    Work from Home, Philippines Cliniqon LLC Full time ₱600,000 - ₱1,200,000 per year

    Are you passionate about making a positive impact in patients' lives from the very first step? At Cliniqon, we're seeking a dedicated Home Health Clinical Intake Coordinator to be the vital link between patients, healthcare providers, and insurance partners — ensuring a smooth and compassionate start to home health care.Responsibilities:Review and evaluate...

  • rcm team lead- home health

    2 weeks ago

    Work from Home, Philippines 97b87990-e144-471e-ac33-d533220c846f Full time ₱900,000 - ₱1,200,000 per year

    CLINIQON IS HIRING FOR RCM TEAM LEADThe Team Lead – Home Health & Hospice Billing is responsible for overseeing the day-to-day billing operations, ensuring accurate and timely submission of claims, and guiding the billing team to meet productivity, quality, and compliance targets. This role requires strong knowledge of Home Health & Hospice billing...

  • permanent remote job- finance

    2 weeks ago

    Work from Home, Philippines Cliniqon LLC Full time ₱300,000 - ₱600,000 per year

    Are you detail-obsessed, proactive, and passionate about making finance operations seamless? Do you have hands-on experience with U.S. invoicing and financial processes? If so, Cliniqon wants you on our teamWe're on the hunt for a Finance and Admin Associate who can hit the ground running and bring structure, accuracy, and clarity to our growing financial...

  • home health medical coder/oasis reviewer

    2 weeks ago

    Work from Home, Philippines RSD Human Resource Management Consultancy Full time ₱720,000 per year

    WORK FROM HOME SET UPWith 1 year HOME HEALTH MEDICAL CODER/OASIS REVIEWER experienceMust be willing to start ASAPMust be willing to work on a night shift scheduleJob Type: Full-timePay: Php50, Php60,000.00 per monthExperience:Home health coding : 1 year (Required)Oasis Coder: 1 year (Preferred)Work Location: Remote

  • medical claims biller

    1 week ago

    Work from Home, Philippines The NeuroCognitive & Behavioral Institute Full time ₱250,000 - ₱750,000 per year

    JOB DESCRIPTION:-Ensures all claims for patient visits, diagnoses and medical procedures are submitted to insurance companies, patients and other payers.-Accurately and timely post insurance payments, calling insurance companies regarding any discrepancy in payments if necessary and follow up claim denials.-Generate aging report, analyze and work on unpaid...

  • Pre-Underwrite Reviewer

    2 weeks ago

    Work from Home, Philippines nightowl consulting Full time ₱40,000 - ₱60,000 per year

    DescriptionAre you great with numbers and enjoy helping people? Then we'd love to talk with you about our Pre-Underwrite Reviewer position. You'll provide underwriting support to the team to ensure a helpful and happy home-buying experience for our customers.Key Responsibilities*Only those with 2+ years of Junior or Underwriting Experience will get an...

  • PERMANENT REMOTE JOB- LEGAL CONTRACTS MANAGER

    2 weeks ago

    Work from Home, Philippines Cliniqon LLC Full time ₱60,000 - ₱120,000 per year

    We are seeking a JD-qualified, experienced Contracting Manager / Lawyer based in the Philippines to join our Global Legal & Compliance Team.This role will focus on drafting, reviewing, and negotiating commercial contracts, ensuring Cliniqon's best practices and interests are protected, while maintaining the highest standards of HIPAA compliance, data...

  • permanent remote job- bilingual paralegals personal injury litigation

    2 weeks ago

    Work from Home, Philippines Cliniqon LLC Full time ₱1,200,000 - ₱3,600,000 per year

    Are you a sharp, detail-oriented paralegal with a passion for litigation and fluency in both Spanish and English? Join Cliniqon as a vital member of our legal team, where your bilingual skills and litigation expertise will directly impact the lives of clients and the success of our firm.What You'll Do:As a key part of our Personal Injury Litigation team,...

  • Claims Specialist

    2 weeks ago

    Work from Home, Philippines Stallion Express Full time ₱144,000 - ₱360,000 per year

    Stallion Express is a Toronto-based company specialising in shipping and logistics solutions for online sellers. Our clients range from part-time eBay sellers to bigger eCommerce web stores, shipping hundreds of packages per dayWe're a dynamic team working towards a common vision: to help Canadian sellers ship parcels at the lowest possible rates. With...