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- ...tasks assigned by managers of the Clients and/or Helpware Requirements At least high school graduate with diploma With clinical experience ~6 months of experience in customer service over phones, email, or live chat ~ Healthcare experience is NOT required...
- ...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...- ...scheduled studies, ensuring proper scheduling based on referrals, verifying paperwork, completing insurance processes, confirming clinical documentation, coordinating with staff, assisting with patient communications, and performing other necessary duties for efficient...
- ..., and compliance standards. Key Responsibilities ~ Assesses patient understanding, barriers, and readiness to learn, using clinical expertise to adjust teaching methods and ensure effective comprehension of health information ~ Provides one on one and group...
- ...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...
- ...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...
- ...recruitment efforts specifically for roles related to Revenue Cycle Management, including but not limited to positions in billing, coding, clinical appeals, and claims management. Develop and implement effective recruiting strategies that consider unique challenges of...
- ...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...
- ...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...
- ...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,...
- ...appeals or audit 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,...
- ...patients with sleep and respiratory conditions. Their mission is to make innovative treatment solutions more accessible for physicians, clinics, and distributors through modern outreach and education. The company’s sales strategy blends direct provider engagement with B2B...
- ...better for everyone. The US Registered Nurse reviews medical requests to make sure services are medically necessary and aligned with clinical guidelines. This role works closely with doctors, care teams, and insurance partners to support safe, appropriate, and cost‑...
Optum
Cebu20 hours ago - ...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
Cebu22 days ago - • Promote and sell Meikatsu pharmaceutical products to doctors, clinics, hospitals, and pharmacies • Build and maintain good relationships with clients • Achieve monthly and quarterly sales targets • Conduct regular field visits and product presentations • Submit sales...
Meikatsu Pharmaceuticals
Cebua month ago - Work Set-up: WFH DUTIES AND RESPONSIBILITIES: Writing client-facing clinical reviews evaluating the authorization requested, documentation support or lack of support for that authorization, evidenced based criteria for that support, and complex clinical evaluation...
ACCPRO International
Cebua month ago - Qualifications: - Registered Medical Technologist and with a valid PRC ID - With comprehensive understanding in the clinical laboratory - With at least two years work experience as a Medical Technologist - With good interpersonal and communication skills - Knowledgeable...
Simon Agribusiness Corporation
Cebua month ago - 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.
Cebu23 days ago - ...Flexible - 8 AM to 5 PM SUMMARY: 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 5 - 10 $ per hour
...qualification to pitching and closing deals. This role is ideal for a self-motivated sales professional with experience selling into U.S. clinical practices and healthcare organizations. You will focus on outbound sales, generating qualified leads, managing pipeline...WRS Health
Cebua month ago
