Executives-Clinicians-Nurses
6 days ago
- Provide world-class service to customers in an accurate, efficient and courteous manner on every case given based on the documents sent to be reviewed using the medical records for the procedures, inpatient stay, surgical cases and benefit cases in every patient given
- Responsible for evaluating the appropriateness of health care and health services provided to patients covered under the plan ensuring that the quality for such care and services meets or exceeds medically accepted standards
- Assess records for any medical history and symptoms to use it as data in approving the case or sending to a higher-level reviewer
- Provide excellent customer service by focusing on providing a great experience
- Provide world-class service to customers in an accurate, efficient and courteous manner on every case given based on the documents sent to be reviewed using the medical records for the procedures, inpatient stay, surgical cases and benefit cases in every patient given
- Responsible for evaluating the appropriateness of health care and health services provided to patients covered under the plan ensuring that the quality for such care and services meets or exceeds medically accepted standards
- Assess records for any medical history and symptoms to use it as data in approving the case or sending to a higher-level reviewer
- Provide excellent customer service by focusing on providing a great experience
● Active PRC – RN License and US-RN License (Mainland or Illinois)
● With at least 2 years hospital bedside experience
Same Posting Description for Internal and External Candidates
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PH Registered Nurses
4 weeks ago
, Metro Manila, Philippines Shearwater CPO® - Home of Clinicians Full timeOverview PH Registered Nurse role at Shearwater CPO - Home of Clinicians. This position coordinates the execution and ongoing quality of the client’s department processes, including telephonic online authorization of routine services, contacting specialty care providers, monitoring patient eligibility, and online data entry of routine...
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Executives-Clinicians-Nurses
6 days ago
Philippines EXL Full time ₱1,000,000 - ₱3,000,000 per yearDescriptionResponsible for the review and evaluation of clinical information and documentation, fax triage and conversion, and provider calls.Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirementsProtects the confidentiality...
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Nurse
4 weeks ago
, , Philippines Ventra Health Full timeVentra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory...
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Philippines Shearwater Health Full time ₱250,000 per yearLet your Passion Lead You at the Home of Clinicians with over 5000+ employees who have trusted us with their careersQualifications:With AHIMA and/or AAPC Coding Credential (CPC, CIC, CCS)At least 1 year of coding experience. Experience in Inpatient coding audit is a plus.Graduate of accredited Registered Nursing Program preferred but not requiredBenefits:Our...
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Nurse
4 weeks ago
, , Philippines Century Pacific Food, Inc Full timeResponsibilities Provide immediate medical care and first aid to employees in case of illness, injury, or emergency. Maintain and update health records, medical logs, and incident reports in compliance with company and regulatory requirements. Conduct regular health assessments, medical evaluations, and assist in pre-employment medical processing. Promote...
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Assistant Nurse Manager
4 weeks ago
, , Philippines The Medical City Full timeThe Medical Clark is dedicated to providing exceptional healthcare services and is committed to the vision and mission of enhancing patient care through innovative practices and a supportive work environment. This role assists the Nurse Manager in planning, organizing, administering, and coordinating activities of Nursing Service towards the vision and...
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USRN with Utilization Management experience
1 week ago
Philippines Shearwater Health Full time ₱25,000 - ₱520,000 per yearLet your Passion Lead You at the Home of Clinicians with over 5000+ employees who have trusted us with their careersPhysical Sites: Taguig, Cebu, and PampangaOur Clinicians & Associates advocates for better patient care while enjoying these benefits:PHP100,000 Sign-On Bonus (for selected accounts)Work from home until further notice (for selected accounts)HMO...
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Nurse - Medical Benefits
4 weeks ago
, , Philippines dnata Travel Group Full timeMedical Claims Processor Minimum requirements Applicants must be willing to work and relocate to Clark, Pampanga. Applicants must be a Filipino citizen or have a relevant residence status. With Bachelors Degree in Nursing or Midwifery. Registered Nurse/Midwife/Dental Nurse Minimum of 2 years hospital experience as Staff Midwife, Staff Nurse or Dental Nurse...
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Philippines Shearwater Health Full time ₱300,000 - ₱600,000 per yearLet your Passion Lead You at the Home of Clinicians with over 5000+ employees who have trusted us with their careersOur Clinicians & Associates advocates for better patient care while enjoying these benefits:Remote Work Setup*With Sign-On BonusCertificate Renewal Coverage*HMO on Day 1 with 2 Dependents upon regularization.Group Life InsuranceHighly...
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Clinical Care Review Specialist
1 week ago
Philippines Medva Full time ₱1 - ₱2 per yearAbout the RoleWe're looking for a Clinical Care Review Specialist to join our growing healthcare support team. This role plays a vital part in improving patient outcomes through thoughtful clinical review, identifying care gaps, and collaborating with providers and care management teams. If you're a seasoned clinician who thrives on structured work, critical...