Fraud Reviewer Specialist - Manila, National Capital Region
1 buwan ang nakalipas
Paglalarawan ng trabaho
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Mga katulad na trabaho
Patient Reviews Specialist (Remote | Healthcare) · Job Summary · We are hiring a Patient Reviews Specialist to support the monitoring and management of patient feedback across online review platforms. This role focuses on responding to reviews, identifying recurring concerns, and ...
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· The Utilization Review Specialist is responsible for managing all aspects of the utilization review process, including preauthorization, Single Case Agreements (SCA), continued authorizations, and collaboration with clinical staff to ensure documentation meets insurance requir ...
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· Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. · Roles and Respo ...
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Date: Feb 26, 2026 · Location: · Metro Manila, QUE, PH · job- { · display: inline; · } · Company: · NTT DATA Services · Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in a ...
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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 ...
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· "Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. · Roles and Resp ...
1 linggo ang nakalipas
"Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. · Roles and Responsi ...
1 linggo ang nakalipas
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 prevent such transactions from happening in the future. The roles and responsibilities include the fo ...
1 linggo ang nakalipas
Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. · Roles and Responsib ...
1 linggo ang nakalipas
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. ...
1 buwan ang nakalipas
The Fraud Reviewer analyzes transaction data to identify fraudulent transactions. · Daily monitoring of suspicious transactions. · Generate insights by analyzing patterns. · ...
2 linggo ang nakalipas
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. · ...
1 buwan ang nakalipas
We are currently seeking a Clinical Reviewer Specialist to join our team in Manila, National Capital Region (PH-00), Philippines (PH). Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for ...
3 linggo ang nakalipas
To independently conduct comprehensive post-review assessments of approved loan accounts. · ...
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Job Summary · We are seeking a highly meticulous and responsible Credit Review Specialist to join our growing Fintech team. In this role, you will be the primary "gatekeeper" of our credit quality, responsible for evaluating loan applications from Filipino consumers. You will use ...
8 oras ang nakalipas
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 ...
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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 ...
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We are seeking a highly meticulous and responsible Credit Review Specialist to join our growing Fintech team. In this role, you will be the primary "gatekeeper" of our credit quality, responsible for evaluating loan applications from Filipino consumers. You will use a combination ...
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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 ...
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We're seeking a licensed medical professional to support a plastic surgeon by reviewing patient consultation submissions and preparing clear, structured consult notes. · ...
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