Fraud Reviewer Specialist - Manila, National Capital Region

· ...

We are currently seeking a Clinical Reviewer Specialist to join our team in Manila.Clinical Reviewer Specialists perform clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance ...

Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal. Ensures timely review, processing, · and response to appeal in accordance with State, Federal and NCQA standards. ...

The Fraud reviewer analyzes transaction data and user behavior to identify fraudulent/ high risk transactions as well as suggest improvements to business processes and systems. · ...

To independently conduct comprehensive post-review assessments of approved loan accounts. · ...

The Documents Review Specialist is responsible for reviewing documentary requirements for SBF loan products. · ...

The Post Review Specialist conducts comprehensive post-review assessments of approved loan accounts to ensure compliance with credit policies and integrity of approval decisions. · Graduate degree in Business Administration, Finance, Accounting or Economics · At least 1-3 years e ...

AvePoint is the global leader in data security, governance and resilience going beyond traditional solutions to ensure a robust data foundation and enable organizations everywhere to collaborate with confidence. · About AvePoint · Beyond Secure. At AvePoint we are committed to in ...

AvePoint's Global Sales Operations team is seeking a full-time Revenue Operations Specialist, Opportunity Review in our Manila office. This is an exciting opportunity to join a high-impact team responsible for ensuring clean, compliant, and timely sales data across our CRM and sa ...

AvePoint's Global Sales Operations team is seeking a full-time Revenue Operations Specialist, Opportunity Review in our Manila office. · Review submitted opportunities and sales contracts to ensure accuracy, compliance with policies, and completeness of required information · Val ...

We are hiring skilled dental Live Scan Review Specialists to support the quality assurance of digital dental impressions taken by dental offices and clinicians. · The role demands extensive dental expertise, strong attention to detail, and strict adherence to established quality ...

We're seeking a licensed medical professional to support a plastic surgeon by reviewing patient consultation submissions and preparing clear, structured consult notes. · ...

The opportunity is to join a globally recognized provider of independent medical examinations and document management services trusted by insurers law firms and government agencies across the US Canada the UK and Australia. · Take on a vital role in conducting IMO research throug ...

ECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia and the Philippines. We are dedicated to a singular purpose: providing the Right People to meet every client's needs and solve business c ...

We are seeking a Medical Review Specialist to join our team in Manila. As a Medical Review Specialist, you will be responsible for reviewing veterans' medical records and providing IMO support. · ...

As a Utilization Review Nurse Specialist at MicroSourcing, you will conduct thorough initial, concurrent, and retrospective reviews of patient medical records to determine the medical necessity and appropriate level of care. · At least 1 year of utilization review experience · Cl ...

We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, · Collaborate with physicians and other healthcare professionals to ensure accurate documentation is provided to payors · Ensure strict compliance with payer requirements and reg ...

The position of US Customer Service and Data Review Specialist is located in the Philippines. · The role is responsible to have customer interaction, high levels of support and time management skills. · ...

Respond to customer tickets through our queue system · Email correspondence with customers to gather information and updated data · Evaluate forms and assess customer needs to give exceptional service · Develop retention strategies to reduce customer churn. · ...

The US Customer Service and Data Review Specialist position is responsible for customer interaction, high levels of support and time management skills. · ...