Clinical Denials and Appeals Manager - Taguig
2 linggo ang nakalipas

Job summary
The Clinical Denials and Appeals Manager is responsible for the day-to-day operations and oversight of initial and concurrent clinical reviews in addition to Clinical Denials processes.This role ensures accuracy in utilization management up to and including the review of the claims denied. This manager ensures the team carries out the appeals process appropriately and in a timely manner. This leader ensures adherence to regulatory guidelines and payer requirements.
Paglalarawan ng trabaho
, consectetur adipiscing elit. Nullam tempor vestibulum ex, eget consequat quam pellentesque vel. Etiam congue sed elit nec elementum. Morbi diam metus, rutrum id eleifend ac, porta in lectus. Sed scelerisque a augue et ornare.
Donec lacinia nisi nec odio ultricies imperdiet.
Morbi a dolor dignissim, tristique enim et, semper lacus. Morbi laoreet sollicitudin justo eget eleifend. Donec felis augue, accumsan in dapibus a, mattis sed ligula.
Vestibulum at aliquet erat. Curabitur rhoncus urna vitae quam suscipit
, at pulvinar turpis lacinia. Mauris magna sem, dignissim finibus fermentum ac, placerat at ex. Pellentesque aliquet, lorem pulvinar mollis ornare, orci turpis fermentum urna, non ullamcorper ligula enim a ante. Duis dolor est, consectetur ut sapien lacinia, tempor condimentum purus.
I-access ang lahat ng mataas na antas na posisyon at makuha ang trabahong pinapangarap mo.
Mga katulad na trabaho
Clinical Appeals Operations Manager
1 buwan ang nakalipas
As Clinical Appeals Operations Manager at MicroSourcing you will oversee daily clinical denials and appeals operations to ensure timely and accurate processing of denied claims. · ...
Denials & Appeals Program Manager
1 buwan ang nakalipas
We are looking for a Denials & Appeals Program Manager to oversee daily Clinical Denials and Appeals operations. · ...
Clinical Denials and Appeals Manager
2 linggo ang nakalipas
The Clinical Denials and Appeals Manager is responsible for the day-to-day operations and oversight of initial and concurrent clinical reviews in addition to Clinical Denials processes. · You will lead a team to achieve specific goals by overseeing daily activities, assigning tas ...
Operations Manager
1 buwan ang nakalipas
The Operations Manager for Appeals is responsible for managing and overseeing operations related to clinical appeals. · ...
Senior BPM Associate
1 buwan ang nakalipas
We have a strong global presence and a dedicated workforce of over 4000 people spread across the world. Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. · Bachelor's degree in business administration, Economics, Health Care, ...
Senior BPM Associate
3 linggo ang nakalipas
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. · ...
Associate BPM Lead
2 linggo ang nakalipas
We are searching for a highly motivated Appeals and Grievances Analyst to join our team. · Acting in a quality assurance capacity, Appeals and Grievances Analysts are responsible for processing appeals and grievances by evaluating the organization's initial decisions against CMS ...
Clinical Denials and Appeals Nurse
1 buwan ang nakalipas
We are seeking an experienced Clinical Denials and Appeals Nurse to join our team as a Team Leader. · ...
Associate BPM Lead
1 buwan ang nakalipas
As an Appeals and Grievances USRN one must be able to effectively process transactions in a timely manner clarify complex transactions ensure quality of output accuracy of information maintained according to SLAs. · ...
Associate BPM Lead
6 araw ang nakalipas
We have a strong global presence and a dedicated workforce spread across the world. Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership.All appeals and grievance cases must be documented in the highest quality possible, · Invest ...
Senior BPM Associate
3 linggo ang nakalipas
UST HealthProof is searching for a highly motivated Appeals and Grievances Analyst to join their team. The role involves processing appeals and grievances by evaluating the organization's initial decisions against CMS guidelines and enrollee benefits, preparing detailed summary s ...
Associate BPM Lead
2 linggo ang nakalipas
We are searching for a highly motivated Appeals and Grievances Analyst to join our team. Acting in a quality assurance capacity, Appeals and Grievances Analysts are responsible for processing appeals and grievances by evaluating the organization's initial decisions against CMS gu ...
Senior BPM Associate
1 linggo ang nakalipas
The Senior BPM Associate will be responsible for processing appeals and grievances by evaluating the organization's initial decisions against CMS guidelines and enrollee benefits. They will also prepare a detailed summary statement of the appeal or grievance case, including resea ...
Senior BPM Associate
1 linggo ang nakalipas
We have a strong global presence and a dedicated workforce of over 4000 people spread across the world. · UST HealthProof is searching for a highly motivated Appeals and Grievances Analyst to join our team.Acting in a quality assurance capacity,Follow Grievances and Appeals proce ...
Associate BPM Lead
3 linggo ang nakalipas
As an Appeals and Grievances USRN one must be able to effectively process transactions assigned in a timely manner clarify complex transactions as needed ensure that quality of output and accuracy of information is maintained according to SLAs. · ...
Associate BPM Lead
1 linggo ang nakalipas
We have a strong global presence and a dedicated workforce of over · 4000 people spread across the world. · This position description identifies the responsibilities · and tasks typically associated with the performance of · the position.All appeals and grievance cases must be ...
Denials & Appeals Program Lead
1 buwan ang nakalipas
A Denials & Appeals Program Lead oversees daily Clinical Denials and Appeals operations to ensure timely and accurate processing of denied claims. · ...
Clinical Denials
4 linggo ang nakalipas
Review claims denied by payors and carry out appeals processes timely. · The Clinical Denials & Appeals Nurse Specialist (IP & OP) identifies denials, evaluates denial reasons including information from payors, · reviews clinical documentation assessing options completing next st ...
Clinical Denials
3 linggo ang nakalipas
As Clinical Denials and Appeals Nurse Specialist – IP & OP you will review claims denied and carry out the appeals process appropriately and in a timely manner. This individual identifies and works denials responding to the denial reason resubmitting any information needed to the ...
Utilization & Denials Management Supervisor
1 buwan ang nakalipas
We are seeking a Utilization & Denials Management Supervisor to oversee Clinical Denials & Appeals staff and ensure timely resolution of clinical denials and appeals issues. · Supervise and support Clinical Denials & Appeals staff including hiring onboarding scheduling performanc ...