operations manager for appeals phrn

Job Title: PHRN – Appeals & Denials NurseWork Setup:On-site, Bridgetowne, Quezon CityShift:Night ShiftSalary Package:PHP 50,762 (Basic: 43,762 + 7,000 Allowance)Signing Bonus:Released on first payout for candidates who can join onDecember 9or immediatelyTarget Start Date:December 9, 2025Headcount:12Role SummaryThe PHRN Appeals & Denials Nurse is...

Operations Manager for Appeals - PHRNLOB DESCRIPTION: Medical necessity review for appeals (Claims denied due to medical necessity)JOB SUMMARY:The Operations Manager for Appeals is responsible for managing and overseeing operations related to clinical appeals, ensuring compliance with industry standards and regulatory requirements. The role involves close...

Operations Manager – Clinical Appeals (PHRN)Bridgetowne, Quezon City | OnsiteNight Shift₱120,000 – ₱150,000Start Date: ASAP / Dec 31, 2025About the RoleWe are looking for an experienced Operations Manager for Clinical Appeals (PHRN) to lead and oversee appeals operations, ensuring compliance with medical necessity review standards, regulatory...

Qualifications:Active Philippine Registered Nurse (PHRN) with License Required1 Year(s) Minimum of Clinical Nursing Experience (Hospital, Clinic, or Managed Care Setting)6 Month(s) Minimum of Clinical Process Outsourcing Experience and Background Handling Clinical Role Focusing on Clinical Appeals and Utilization Management and Other Related FunctionStrong...

We are actively hiring a Philippine Registered Nurse (PHRN) with experience in BPO Prior Authorization and Appeals. Join our growing team in Bridgetowne, QC and be part of a company that offers competitive compensation, career growth, and a supportive work environment.Qualifications:Must be a PHRN (Active PRC license)At least 1 year BPO experience handling...

Role Title: USRN/PHRN Operations ManagerECLARO: A quick SummaryECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia and the Philippines. We are dedicated to a singular purpose: providing the Right People to meet every client's needs and solve business challenges through...

Job Title: PHRN Appeals DenialsShift: Night shiftWork Set-up: Onsite in Bridgetowne, Quezon CitySalary range: 50,762 package (Basic:43,762 and Allowance: 7K) with signing bonus to be released on their first payout for those who can join on Dec 9th/ImmediatelyTarget Start Date: December 9, 2025Headcount: 12Recruitment Process: VirtualQUALIFICATIONS:• An...

Job Title: PHRN CLINICAL TRAINERShift: Night shiftWork Set-up: On-site in Bridgetowne, Quezon CityStart date: Dec 31, 2025/ ASAPRecruitment Process: 2 Virtual interview processesQUALIFICATIONS:• Bachelor's Degree in Nursing with an active and valid license in PHRN• Must have at least 2 years experience in utilization management and medical necessity...

Job Summary:The Manager Operations is responsible for coaching and supervising a group of Team Leaders. This position is also responsible for ensuring Client Service Level Agreement and financial expectations are achieved.Essential Duties and Responsibilities:• Analyze and maintain all Client Service Level Agreements; implement improvement plans as...

CLINICAL LEADERSHIP HIRING2 PHRN Training & Quality ManagersSalary: 150,000 PHP + 10%Locations: 1 for Ortigas, 1 for QCQC – PHRN Healthcare Training & Quality ManagerSalary Range: 130,000 – 150,000 PHPRequirements:Minimum 2 solid years of PHRN Healthcare Training & Quality Manager experienceStrong background in UMR, Appeals, Denials, and InterqualSolid...