Appeal Writer

5 days 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-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.

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