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- ...Job Description: We are seeking a detail-oriented, knowledgeable, and proactive Clinical Quality Auditor to help ensure the integrity and quality of our clinical appeals. As an internal team member, you'll have the advantage of already being familiar with our processes...
60000 - 90000 Php
...dedicated team at HBiz where we strive to provide outstanding care and service excellence. We are currently seeking a highly skilled Clinical Appeals Nurse to play a crucial role in managing medical denials by providing clinical expertise in the appeals process. This...- ...CLINICAL CODING ANALYST Key Responsibilities: Review and analyze claims that have been denied due to coding-related issues, including diagnosis codes (ICD-10-CM), procedure codes (CPT/HCPCS), and related modifiers. Identify coding discrepancies, documentation...
- ...SENIOR CLINICAL CODING TEAM LEADER Key Responsibilities: Lead and mentor clinical coding analysts, serving as the primary escalation point for complex, high‑risk, or high‑value coding and denial cases Provide functional leadership to ensure coding quality standards...
22000 - 27000 Php
...clients' contact details through research and keep record of them in the sales CRM • Makes cold calls, follow-ups with health-care clinics, doctors, owners, and office managers • Answers incoming calls and gives proper information • Makes follow-ups on website...- ...Government Benefits Administration • Lactation breaks (for breastfeeding moms) • Discounted optical services with our partner clinic • Free lunch/dinner and unlimited coffee and ice cream daily (for on site employees) • Free Health insurance with one (1)...
- ...wellness center expanded in the Philippines while having a strong brand in Singapore, Philippines, Japan and other countries. This clinic has Japanese doctors, Medicines from Japan, Japanese consultation and even a Japanese medical help desk and emergency line. Position...
- ...experience in case management or care coordination, with at least [insert number of years] years in a leadership role. • Strong clinical assessment and critical thinking skills. • Excellent communication and interpersonal skills. • Knowledge of healthcare regulations...
- ...revenue, reduce operational costs, and improve patient care. Job Summary: We are seeking a highly motivated and experienced Clinical Case Management Nurse to join our team. The Clinical Case Management Nurse will play a crucial role in supporting our clients in the...
- ...tools in multi-tenant environments. Knowledge ~ Working knowledge of U.S. hospital administrative structures, including clinical, financial, and operational leadership hierarchies. Foundational understanding of the U.S. insurance reimbursement system,...
- ...regulations related to hospital stays, and the prevention of denials. Embedded within our utilization review management platform are clinical criteria guidelines, streamlining the review and documentation process. The Utilization/Risk Management department conducts...
- ...diagnoses (CC/MCC), procedures, and DRG assignment. • Analyze payer denials involving: o DRG downgrades o Removal of CC/MCC o Clinical validation denials o Coding validation disputes • Prepare clear, concise, and compliant DRG appeal letters supported by: o...
- ...appeals or audits. Prepare and submit claim audit packets for internal review or external payor reconsideration. Collaborate with clinical staff, coders, and billing teams to resolve discrepancies and correct claim data. Maintain accurate tracking of denied claims,...
- ...role focuses on ensuring safe transitions of care, reducing readmissions, and improving patient outcomes through timely outreach, clinical assessment, education, and coordination. This position is based in Ormoc, Leyte, Philippines, and supports U.S. patient populations...
- Requirements: Bachelor’s/College degree required. At least 2-3 years of experience in a clinic, healthcare setting, hospitality, or customer relations role. Strong communication skills and a passion for delivering excellent patient care. Organized, detail-oriented,...
Dempsey Inc.
Cebu18 days ago - ...RN) license preferred, but not required. Open to candidates without a license who have hands-on experience through hospital or clinical internships. Strong communication skills, both spoken and written. Strong listening, problem-solving, and follow-up skills....
- ...hours are 8 AM - 5 PM JOB OVERVIEW: Medical Sales Representative promotes and markets Medical products and equipment in hospitals, clinics, diagnostic facilities, etc. The role involves driving product sales, developing client relationships, managing collections, and...
ACCPRO International
Cebua month ago - ...COMPANY PROFILE: Japanese Healthcare and medical center located in Cebu city. This clinic has Japanese Doctors and Medicines from Japan, Japanese consultation, and emergency line and offers 24/7 health assistance to Japanese and foreigners located in Cebu City. This...
