- Contact insurance carriers to verify patient's insurance eligibility, benefits, and requirements.
- Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
- Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.
- Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
- Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial.
- Prioritize the incoming authorizations by level of urgency to the patient.
- Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
- Respond to clinical questions regarding payer medical policy guidelines.
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company nurse
2 araw ang nakalipas
City Advertising Ventures Corporation Metro Manila / NCR, Pilipinas Buong orasJOB DESCRIPTION: Administer First Aid care and treatment when needed. · Conduct preliminary check up to sick employees and dispense medicines if necessary. · Review medical certificate provided by the employees. · Maintains employee health records to ensure continuity of care, ...
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Nurse Trainer
2 araw ang nakalipas
MICHAEL PAGE INTERNATIONAL RECRUITMENT (PHILIPPINES) INC. Manila, Philippines, Pilipinas Buong orasBe part of the pioneering team for a new health app segment · Join a local high flying company with 50% market share in transpo business · About Our Client · A local transportation company starting its new healthcare business segment. · Job Description · Responsible for measuring ...
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MDS Coordinator
2 araw ang nakalipas
Tamaray People Solutions Corp. (TPS) Metro Manila / NCR, Pilipinas Buong orasPosition: Managerial · Salary: 60,000-80,000 · Site assignment: Hybrid Setup · Start Date: ASAP · Qualifications:PH or US Registered Nurse with active license · Has actual MDS Coordination experience for a nursing home - knowledge only is not enough. · Excellent English commun ...
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Customer Service Representative
1 linggo ang nakalipas
RecruiterPH McKinley West, Taguig, Pilipinas PermanentResponsible for interviewing patients, retrieve and review information to compose accurate and complete medical records. · College Degree – BS Nursing or other Medical allied course. · Communication and listening skills · Excellent command of written English · Writing Skills ...
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Quality Assurance
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Microsourcing Philippines Inc Metro Manila / NCR, Pilipinas Buong orasAudits & Quality Assurance Coordinator · Â · Essential Duties: · Working with the Customer Care, Revenue Cycle Management, Clinical, Sales and Finance departments, the Medicare Audits & Quality Assurance (QA) Coordinator is responsible for post service review of patient medical r ...
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Cardiovascular Technician
3 araw ang nakalipas
TASQ Staffing Solutions Metro Manila, Pilipinas Buong orasJob DescriptionWe are seeking a dedicated and skilled Cardiovascular Technician to join our healthcare team. As a Cardiovascular Technician, you will play a crucial role in assisting physicians in diagnosing and treating patients with heart and vascular conditions.***Locations: A ...
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Underwriting Associate
6 araw ang nakalipas
SOURCETECH SOLUTIONS INC. Manila, Pilipinas ContractJob Description:The underwriting associate assesses client risk, evaluates policies based on company standards, and makes decisions on insurance applications. They also handle data extraction for analyses, compile monthly renewal lists, and manage document reviews and uploads to ...
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Remote Patient Monitoring Specialist
1 linggo ang nakalipas
Rippedbox Station Manila, Pilipinas RemotePosition: Remote Patient Monitoring SpecialistNumber of hours: 40 hours/weekCompany Overview:Our client is a leading healthcare provider dedicated to delivering high-quality patient care. We are committed to leveraging innovative technologies to improve patient outcomes and enhan ...
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Remote Patient Monitoring Specialist
7 oras ang nakalipas
Ripped box station Metro Manila, Pilipinas RemotePosition: Remote Patient Monitoring SpecialistNumber of hours: 40/ hoursSchedule: TDBCompany Overview: Our client is a leading healthcare provider dedicated to delivering high-quality patient care. We are committed to leveraging innovative technologies to improve patient outcomes ...
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Clinic Manager-Manila
2 araw ang nakalipas
Drake International Philippines Manila City, PilipinasDrake's top client – a network of multi-specialty medical clinics is currently hiring a Clinic Manager to be part of their collaborative team in Robinson Place Manila. · Core function: · We are looking for a Clinic Manager to ensure smooth and efficient daily operations of the c ...
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Medical Review Specialist DME
3 araw ang nakalipas
Med Supply US Manila, Pilipinas Remote na trabaho Buong orasMed Supply US is one of the nation's leading home medical supply companies with years of experience serving patients with complex medical needs. We offer a full scope of Continuous Glucose Monitors (CGMs) and other diabetes products and services. We have built a collaborative cul ...
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Remote Patient Monitoring Specialist
6 araw ang nakalipas
Rippedboxstation Manila, PilipinasPosition: Remote Patient Monitoring Specialist · Number of hours: 40 hours/week · Company Overview: · Our client is a leading healthcare provider dedicated to delivering high-quality patient care. We are committed to leveraging innovative technologies to improve patient outcomes ...
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Credentialling Specialist
1 linggo ang nakalipas
Elevate Calls Inc Manila, PilipinasJob Title: Credentialing Specialist (Healthcare Account) · Company: Elevate Calls Inc. · Location: Remote (Permanent Work From Home Position) · Position Overview:We are seeking a dedicated and detail-oriented Credentialing Specialist to join our team. As a Credentialing Specialis ...
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Customer Execution and Clinical Monitoring Specialist
6 araw ang nakalipas
Rippedboxstation Manila, PilipinasJob Title: Customer Execution and Clinical Monitoring Specialist · Number of hours: 40hours/week · Responsibilities: · Screens patients for Medicare and insurance eligibility to receive RPM, CCM, RTM & PCM services. Communicates weekly patient enrollment schedule. · Welcomes pa ...
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Medical Prior Authorization
3 araw ang nakalipas
Med Supply US Manila, Pilipinas Remote na trabaho Buong orasMedical Prior Authorization-Insurance Verification Specialist · Position Summary: · The Prior Authorization Specialist plays a crucial role in the healthcare industry by ensuring that medical services, procedures, and medications are approved by insurance companies or third-party ...
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Content Developer
3 araw ang nakalipas
Course Hero Manila, Pilipinas Buong oras· Course Hero is scaling Are you a college educator looking to leverage your pedagogic chops to help students learn? Course Hero is looking for Content Developers in Medical Science to ensure that we are creating the highest quality solutions to questions. Our ideal candidates w ...
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World Health Organization (WHO) Manila, Pilipinas· JOB DESCRIPTION · Purpose of consultancy · The consultant will support the collection and reporting of data and information on NTDs, supply of donated NTD drugs and diagnostics, and provide operational and technical support to accelerate control and elimination of neglected tr ...
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Company Nurse
4 araw ang nakalipas
Lifestrong Marketing Inc. Caloocan, Pilipinas Buong oras- Prepares and submits monthly employee health monitoring reports- Facilitates company related activities as assigned by the HR Manager- Updating of bulletin for Health-related announcements- Daily review of employee health symptoms form- Develop and implement health and safety p ...
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Occupational Health Nurse
2 linggo ang nakalipas
TOPSERVE SERVICE SOLUTIONS INC Caloocan, Pilipinas Buong orasRole DescriptionThis is a full-time on-site role for an Occupational Health Nurse. The Occupational Health Nurse will be responsible for providing nursing care and clinical services to employees, conducting occupational health assessments, identifying and managing occupational he ...
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Physician Assistant/ 14k-16k/ Cebu/ Davao
1 linggo ang nakalipas
Dempsey Resource Management Inc San Juan, Pilipinas Buong orasResponsibilities:- Interviewing, examining, and diagnosing patients' injuries and illnesses.- Ordering and interpreting diagnostic tests.- Prescribing medications and suggesting lifestyle changes.- Stitching wounds, setting bones, assisting in surgeries, and administering immuniz ...
Utilization Review Nurse - Metro Manila / NCR, Pilipinas - AGS Health LLC
Paglalarawan
Dear Candidate,Greetings from AGS Health.
We are happy to share our job opening.
Job title- Utilization review nurse
Mode of work - Onsite
Location – Cyber sigma, Lawton Ave, Mckinley West, Taguig, 1634 Metro Manila, Philippines
Responsibilities:
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Mga gumagamit ng propesyon na Utilization Review Nurse sa Manila
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Renante austria
I would like to apply in Canada, for any available position that will suit my qualifications. I am a ...