Clinical Denials - Taguig
4 linggo ang nakalipas
You'll Have Competitive Rewards: Enjoy above-market compensation , healthcare coverage on day one , plus one or more dependents , paid time-off with cash conversion , group life insurance , and performance bonuses A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements Career Growth: Take advantage of opportunities for continuous learning and career advancement Inclusive Teamwork: Be part of a team that celebrates diversityand fosters an inclusive culture The Clinical Denials & Appeals Nurse Specialist (IP & OP) is responsible for reviewing claims denied carrying out appeals process appropriately in timely manner .
The Clinical Appeals Experience At least year clinical appeal writing experience Clinical Experience Minimum years acute care clinical experience hospital setting Med/Surg similar preferred ICU experience Education Bachelor Science Nursing Licensure Must Registered Nurse active PHRN USRN license RCM Knowledge Proficiency using InterQual MCG clinical guidelines Broad Knowledge U.S Government Programs Insurance Regulations Software Knowledge Proficiency hospital-based electronic medical records EMR Epic Cerner Meditech Excellent verbal written English communication skills customer service skills CEFR level both verbal written Preferred Skills/expertise Education Master degree credential business healthcare related field Case management clinical appeals denials certification ACMA preferred CertificationProficiency computer programs tracking denials appeals Microsoft Office suite Excel Word PowerPoint Outlook SharePoint Soft SkillsAbilty pay close attention details strong follow follow-through skills Regularly makes complex decisions scope position comfortable working independently Requires use independent judgment discretion decision-making abilities Demonstrates teamwork integrity all wrk-related activities Ability interact internal external customers professional manner Strong analytical critical thinking skillexperience matrixed environment Excellent written verbal communication skillessaysMicroSourcing pioneer largest offshore provider managed services Philippines Our commitment % YOU MicroSourcing firmly believes our company strength lies people's diversity talent We proud foster inclusive culture embraces individuals races genders ethnicities abilities backgrounds provide space everyone embracing different perspectives making room opportunities each individual thrive equality not merely slogan - way life Here don't just accept unique authentic self-we celebrate valuing every individual contribution collective success growth Join us celebrating YOU your
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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 ...
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