Licensed Appeal Writer

8 hours ago

Pasig, National Capital Region, Philippines Med-Metrix Full time ₱900,000 - ₱1,200,000 per year

Job Description

Join our dynamic team and make a meaningful impact in the healthcare industry. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others every day. Take the next step in your career with Med-Metrix

Experience these exceptional benefits when you join Med-Metrix

  • 8-Hour Shifts
  • Day 1 HMO with 2 of your dependents covered for FREE
  • Medical Cash Allowance
  • Rice Allowance
  • Clothing Allowance
  • Free Lunch Daily
  • Paid Time Off
  • Training and Staff Development
  • Employee Engagement Activities
  • Opportunities for Internal Mobility

Job Purpose

The Appeal Writer supports the organization by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Appeal Writer creates appeal letters in support of claim payment.

Duties and Responsibilities

  • Review denied insurance claims
  • Review patients' medical files
  • Develop strategies to reverse claim denials
  • Create written appeals
  • Manage and organize appeal workflow based on internal, client-based, and insurance-driven deadlines
  • Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Qualifications

  • Must be a Registered Nurse. US RN, not required
  • Must have at least 1 year of experience in a hospital setting
  • Must be able to prioritize workload based on strict deadlines
  • Must be a strong, effective writer
  • Must be tech-savvy with ability to quickly learn new software
  • Must possess a high level of reading comprehension and ability to analyze medical information and terminology
  • Thorough training provided

Working Conditions

  • Work Set-Up: Onsite
  • Work Schedule: Night shift, US hours
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
  • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.


  • Appeal Writer

    2 weeks ago

    Pasig, National Capital Region, Philippines Med-Metrix Full time ₱900,000 - ₱1,200,000 per year

    Join our dynamic team and make a meaningful impact in the healthcare industry. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others every day. Take the next step in your career with Med-MetrixExperience these exceptional benefits when you join Med-Metrix8-Hour ShiftsDay 1 HMO with 2 of your dependents...

  • Clinical Appeals Nurse Writer

    4 days ago

    Pasig, National Capital Region, Philippines Coronis Health Full time ₱1,200,000 - ₱2,400,000 per year

    JOB SUMMARY:The Clinical Appeals Nurse is responsible for creating a convincing and effective appeal based on clinical documentation, payer-specific standards, and compliance with federal and state policies. The Clinical Appeals Nurse is responsible for handling clinical denial appeals and follow-up, providing relevant denial information to departments to...

  • Fashion Writer

    2 weeks ago

    Pasig, National Capital Region, Philippines AGC Power Holdings Corp Full time ₱40,000 - ₱60,000 per year

    Company DescriptionAGC Power Holdings Corp. (AGC PHC) is an investment management company dedicated to supporting aspiring Filipino entrepreneurs in building successful businesses. As the parent company of several high-performing multimedia companies, AGC PHC includes renowned names such as One MEGA Group Inc., Mega Global Licensing Inc., Modern Media Group...

  • Clinical Appeals and Denials PHRN

    6 hours ago

    Pasig, National Capital Region, Philippines Swift-up Full time ₱900,000 - ₱1,200,000 per year

    The PH Registered Nurse (PHRN) collaborates with healthcare providers and members to promote quality outcomes, optimize member benefits, and ensure the effective use of healthcare resources. This role ensures that care provided is medically appropriate, high-quality, and cost-effective by reviewing medical necessity for inpatient admissions, outpatient...

  • Digital Content Writer

    1 week ago

    Pasig, National Capital Region, Philippines AGC Power Holdings Corp Full time ₱40,000 - ₱60,000 per year

    Company DescriptionAGC Power Holdings Corp. (AGC PHC) is an investment management company dedicated to supporting aspiring Filipino entrepreneurs in building successful businesses. As the parent company of several high-performing multimedia companies, AGC PHC includes renowned names such as One MEGA Group Inc., Mega Global Licensing Inc., Modern Media Group...

  • Fashion Writer

    7 hours ago

    Pasig, National Capital Region, Philippines AGC Power Holdings Corp Full time ₱400,000 - ₱600,000 per year

    Role DescriptionThe Fashion Writer develops and writes fashion stories and fashion features for the magazine. He/she must be passionate about the latest fashion trends and personalities and be able to bring creative ideas to life. He is also responsible for producing written content for both print and digital assets.Key ResponsibilitiesWrite and develop...

  • LinkedIn Marketing Specialist

    2 weeks ago

    Pasig, National Capital Region, Philippines Azeus Systems Limited Full time ₱1,200,000 - ₱2,400,000 per year

    Responsibilities:Developing and managing the overall social media strategy for the productPlanning, designing, and implementing campaigns on social media especially LinkedIn to boost brand awarenessMonitoring, analyzing, and reporting on website performance and marketing metricsTapping into online platforms such as Facebook, LinkedIn and GoogleWorking with...

  • 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. stateMinimum 2 years of hospital or bedside experience in an acute care setting (Med/Surg, Ortho, ER)Experience using InterQualStrong analytical and clinical judgment skillsKey Responsibilities:Review and analyze denied inpatient claims and determine reasons for denial following IP DRG coding guidelinesPrepare...

  • Clinical Review Nurse

    2 weeks ago

    Pasig, National Capital Region, Philippines Connext Global Solutions Inc Full time ₱900,000 - ₱1,200,000 per year

    About ConnextConnext is a team of business process outsourcing experts serving world-class clients in industries like Healthcare, Title and Escrow, Retail and Fashion, Produce Distribution, Design Consulting, and Finance.We are currently hiring a Clinical Review Nurse to work with one of our healthcare clients based in the U.S. What's in it for...

  • Quality Analyst

    2 weeks ago

    Pasig, National Capital Region, Philippines Omega Healthcare, Ortigas Pasig City Full time ₱25,000 - ₱35,000 per year

    Primary Duties and Responsibilities:We are currently looking for a keen individual who is responsible for conducting audits for healthcare account. The role includes providing feedbacks, ratings, coaching tips for the agents, all of which must be communicated to agents and their assigned team leadKey Accountabilities:· Delivers required number of QA...