USRN – Denials
2 weeks ago
Pasig, National Capital Region, Philippines
Global Group Innovative Services
Full time
₱1,080,000 - ₱1,140,000 per year
Qualifications:
- Active USRN license in any U.S. state
- Minimum 2 years of hospital or bedside experience in an acute care setting (Med/Surg, Ortho, ER)
- Experience using InterQual
- Strong analytical and clinical judgment skills
Key Responsibilities:
- Review and analyze denied inpatient claims and determine reasons for denial following IP DRG coding guidelines
- Prepare and submit appeal documentation, gathering relevant evidence from medical records
- Ensure accuracy, compliance, and timeliness in all case reviews and appeals
- Collaborate with internal teams to maintain high-quality outcomes
Job Types: Full-time, Permanent
Pay: Php90, Php95,000.00 per month
Work Location: In person
