USRN – Denials

6 days 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



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