Appeals jobs in Pasig

Job description Key Responsibilities: Denials and Appeals Management: Review and evaluate denied claims, including payer policies and clinical documentation Submit retro-authorizations in response to authorization denials Conduct medical necessity reviews and prepare supporting clinical summaries Wr

Clinical Appeals and Denial Management Specialist (Appeals Writing)Job Summary The Clinical Appeals and Denial Management Specialist is responsible for reviewing denied medical claims, preparing clinical appeal letters, and coordinating with providers, payers, and internal teams to ensure appropriat

Swift-up

₱70,000 - ₱75,000 /year

Clinical Appeals and Denial Management Specialist (Appeals Writing) Job Summary The Clinical Appeals and Denial Management Specialist is responsible for reviewing denied medical claims, preparing clinical appeal letters, and coordinating with providers, payers, and internal teams to ensure appropria

Collaboration & Support Effectively communicate the team's performance in Operations Meeting, including reporting on KPIs, progress, and opportunity areas. Work closely with HIM, Revenue Integrity, Coding, Billing, and Clinical departments to ensure clean claim generation. Support coding accurac

LOOKING FOR FILIPINO CANDIDATES RESIDING IN THE PHILIPPINES. We are hiring for Clinical Appeals Writer! Qualifications Basic Clinical Appeals writing experience At least 1+ years of Clinical / Hospital Experience. BS Nursing graduate. With an active PHRN / USRN License Strong familiarity with using

Role Description UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members well-being. With our commitment to simplicity, honesty, and leadership, we

MASS HIRING (12 HEADCOUNT) Position: RN/USRN – Clinical Denials & Appeals Location: BGC, Taguig (Full Onsite) Salary: Up to Php 75,000 per month Requirements: Bachelor of Science in Nursing graduate Active RN / USRN license At least 1 year experience in writing clinical appeals At least 3 years

Profile Summary: This role involves preparing and writing clinical appeals for denied insurance claims, leveraging acute care and ICU nursing experience to ensure accurate medical justification. The nurse will work closely with U.S. insurance guidelines, hospital EMRs, and appeal tracking systems to

ccess Healthcare is looking for REGISTERED NURSE to join our growing team. You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed. Responsibilities : Perform advanced level w

Job Responsibilities Conduct thorough reviews of denied inpatient claims to identify denial reasons, with a strong focus on Inpatient (IP) DRG coding guidelines . Validate that medical records and clinical documentation fully support the billed diagnoses and procedures, ensuring compliance with esta

Role Summary The Clinical Denials & Appeals Nurse Specialist (Inpatient & Outpatient) is responsible for reviewing denied insurance claims and managing the appeals process in a timely and accurate manner. The role involves identifying denial reasons, analyzing clinical documentation, and pre

Salary: PHP 30,000- PHP 35,000/ month Job Description: Track and manage accounts receivable, ensuring aging amounts remain within targeted levels. Regularly check the status of submitted claims to ensure timely processing and payment. Resubmit claims for appeal as necessary, working to resolve any i

R1 RCM PHILIPPINES, INC . seeks an experienced Registered Nurse with Clinical Appeals experience to join our team. This is a full-time position where you will be responsible for crafting persuasive and accurate appeal letters at various levels of appeal. Qualifications & experience At least 2 ye

Discover your 100% YOU with MicroSourcing! Position: Clinical Denials & Appeals Nurse Specialist – IP & OP Location: Taguig Work setup & shift: Onsite | Night shift Sign-on bonus: 50,000* Why join MicroSourcing? You'll Have Competitive Rewards: Enjoy above-market compensation, healthcare

Discover your 100% YOU with MicroSourcing! Position: Clinical Denials & Appeals Nurse Specialist – IP & OP Location: Taguig Work setup & shift: Onsite | Night shift Sign-on bonus: 50,000* Why join MicroSourcing? You'll Have Competitive Rewards: Enjoy above-market compensation, healthcare

Non‑Negotiables; Experiences: -1-year clinical appeal writing -3–5 years acute care (Med/Surg preferred); 2–3 years ICU. -Education: BS in Nursing. -Licensure: Active PHRN or USRN. -Knowledge: InterQual/MCG guidelines, U.S. insurance regulations, hospital EMRs (Epic, Cerner, Meditech). -Skills: Stro

Key Responsibilities: Denials and Appeals Management: Review and evaluate denied claims, including payer policies and clinical documentation Submit retro-authorizations in response to authorization denials Conduct medical necessity reviews and prepare supporting clinical summaries Write and submit d