Appeals/Claims Specialist - Pasig, National Capital Region

This role involves handling prior authorization, appeals, and ARs in a healthcare account with a Registered Nurse (PHRN) license. · ...

The DRG Appeals Specialist will review medical records to validate diagnoses, procedures, and DRG assignment. They will analyze payer denials, prepare appeal letters supported by guidelines and industry references, defend secondary diagnoses assignments based on provider document ...

The Clinical Appeals Specialist (PHRN) is Responsible for the Review, Processing, and Resolution of Appeal(s) Case(s) in Compliance with NCQA and if Applicable, CMS Regulatory Standard(s) and Client Specific Guideline(s). · ...

We are seeking a detail-oriented Claims Specialist to manage life and non-life insurance claims. · ...

Hello! Are you looking for a challenging role that combines your passion for education and healthcare? · We have an exciting opportunity for a Denials & Appeals Education Specialist to join our team at MicroSourcing! · You will be responsible for delivering end-to-end process tra ...

We are looking for a Denials & Appeals Compliance Specialist to support our QA program build by identifying key audit areas, critical workflow aspects, and automation opportunities to enhance efficiency. · ...

Claims processors are involved in managing a claim from beginning through to settlement. · ...

Immediate Hiring: Onsite Night Shift | BGC Claims Specialist job is available for immediate hiring on onsite night shift in Bonifacio Global City. · ...

The Claims Specialist manages claim appeals evaluates next steps—whether submitting additional appeals or closing accounts. They prioritize work based on claim complexity maintain accuracy compliance efficiently process high volumes low‑balance claims support timely payments maxi ...

The Claims Resolutions Specialist is responsible for preparing and submitting appeals for denied claims, addressing escalated claims, investigating underpayments, and closing accounts when collection efforts have been exhausted. · ...

We are hosting an on-site walk-in application event and would love to meet you in person · Why join MicroSourcing? · You'll have:Competitive Rewards: · Enjoy above-market compensation, · A Collaborative Spirit: · Contribute to a positive and engaging work environment by participa ...

The Insurance Email Specialist is responsible for managing and responding to inbound and outbound insurance-related email communications. · Accurate timely and compliant handling of policy inquiries endorsements claims support and general insurance servicing requests while mainta ...

This is an everyday opportunity to do your life's best work in providing confidence in the exceptional care we offer to our members, families, facilities, and health professionals. · ...

Analyze and evaluate insurance claims for payability or deniability. · ...

The ideal candidate will have a basic understanding of healthcare claims and reimbursement processes. · ...

A pioneer in the business WINEBRENNER & IÑIGO is one of the fastest-growing and largest brokers in the Philippines highly respected in the local insurance industry and well-known for its personalized service. · ...

ISTA Solutions seeks an experienced Healthcare Customer Service Representative to join their team in Mandaluyong. · At least 6 months of Healthcare experience. · Above average verbal and written English communication skills. · ...

We are seeking an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals who prioritize employee satisfaction and work-life balance. · Review and p ...

+This job offers a competitive salary and benefits package for experienced Healthcare Customer Service Representatives. The role involves reviewing and processing ambulance insurance claims, working directly with clients, and maintaining accurate claim records. · ...

+Job summary · Claims Processors manage claims from beginning to settlement ensuring efficient handling and payment for valid claims. · +ResponsibilitiesInteract with customers for inquiries regarding products and services. · ...