Medical Review Specialist

Responsibilities:Develop full understanding of each medical and claim payment policy, to ensure accurate diagnosis and procedure code assignment. Understand CMS/regulatory requirements, IBX/AH benefit structure, managed care rules (e.g., HMO Capitation, PPO Network Rules) and other business rules to assure diagnosis and procedure code alignmentReal-time...

1 OpeningTaguigRole descriptionDevelop full understanding of each medical and claim payment policy, to ensure accurate diagnosis and procedure code assignment. Understand CMS/regulatory requirements, IBX/AH benefit structure, managed care rules (e.g., HMO Capitation, PPO Network Rules) and other business rules to assure diagnosis and procedure code...

Job Description:The Reviewer is responsible for assessing the delivery of medical services to determine if the care provided is appropriate, medically necessary, and of high quality. This includes examination of documents to see if patients are given care consistent with their needs as well as inputting of approved Guidelines and References. The review...

The Reviewer is responsible for assessing the delivery of medical services to determine if the care provided is appropriate, medically necessary, and of high quality. This includes examination of documents to see if patients are given care consistent with their needs as well as inputting of approved Guidelines and References. The review typically involves...

Are you in medical sales and passionate about driving healthcare innovation and building strong client relationships in theSurgicalfield? If so, this opportunity could be for you Join us at B. Braun, a leader in the medical devices industry, where your skills and experience will be recognized and celebrated. Take the next step in your career with us and help...

Job title: Medical Billing SpecialistAccount: Healthcare - RCMWork set up: On-site at One World Square, McKinley, Taguig CityWork shift: Shifting schedule and may work during holidaysSalary: 25K-33KStart date: ASAPQualifications:• At least High School (old curriculum) graduate | SHS Graduate | Associate or VocationalGraduate or Undergraduate | College...

Job Summary:We are seeking a detail-oriented and experienced In-Patient Medical Coder to support accurate and compliant coding of inpatient medical records. The role involves reviewing clinical documentation and assigning appropriate diagnosis and procedure codes to ensure timely and accurate billing processes. The ideal candidate has a strong command of...

Discover your 100% YOU with MicroSourcingPosition:Medical Content AnalystLocation:GSC Tower, BGC, Taguig CityWork Set-up & Shift:Work From Home and Night ShiftPosition SummaryTheMedical Content Analystwill be responsible in conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or...

Position Title: DRG Clinical Validation AuditorUSRN with at least 2 years of bedside experienceCandidates must have 1-2 years of hospital coding

Let your Passion Lead You at the Home of Clinicians with over 5000+ employees who have trusted us with their careersPhysical Sites: Taguig, Cebu, and Pampanga Our Clinicians & Associates advocates for better patient care while enjoying these benefits:PHP100,000 Sign-On Bonus (for selected accounts)Work from home until further notice (for selected...