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- ...Key Responsibilities Review denied medical claims to determine reasons for denial (coding errors, missing information, medical necessity... ...payor reconsideration. Collaborate with clinical staff, coders, and billing teams to resolve discrepancies and correct claim data...
- ...The Medical Device Complaints Team Lead is responsible for overseeing the day-to-day operations of the complaints handling team, ensuring timely and compliant processing of customer complaints related to medical devices. This role supports quality and regulatory requirements...
- ...operational solutions to health systems, physician groups, or specialty medical practices. Our mission is to improve the overall financial... ...Qualifications: ~ Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Inpatient Coder...
- ...and ensuring compliance with payer contracts, coding guidelines, and regulatory standards. The analyst collaborates with providers, coders, billing teams, and payers to optimize claim performance and minimize denials or payment delays. Key Responsibilities Review...
- ...Cebu (CEB) Start Date: May 11 Qualifications: Must have a Medical Coding License (CPC or CIC) (non-negotiable) At least 3 years... ...Permanent work-from-home setup Non-voice account (less stress environment) Great opportunity for experienced medical coders
Metacom
Cebu17 days ago - ...Insurance for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End...
- ...concurrent, and retrospective reviews for authorization of Levels of Care (LOCs) and services, engaging with Program Managers, reviewing medical necessity records, and liaising with individuals and their families when necessary. Additionally, the department handles billing...
- ...for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party...
- ...mindset who thrives in a fast-paced contractor environment. What You’ll Do You’ll be the kind of person who: Organise medicals, police checks, and inductions. Manage candidates closely to minimise mobilisation delays. Arrange travel for employees....
- ...compliance with global pharmacovigilance regulations (FDA, EMA, ICH guidelines) • Coordinate case follow-ups with QA, Regulatory, Medical, and Clinical teams • Maintain data integrity, quality standards, and audit readiness • Support continuous improvement of...Remote job
- ...for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party...
- ...ll enable the future — starting with yours.Top reasons to work with TDCX * Attractive remuneration and great perks * Comprehensive medical, insurance, and social security coverage * World-class workspaces * Engaging activities and recognition programs * Strong learning...
- ...for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party...
- ...for you and one free dependent from day one (with the option to enroll additional dependents). Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary). Employee Engagement Activities: Year-End Party...
- ...Dental, and Life Insurance for you and one free dependent from day one (with option to enroll more) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party,...
- ...automotive leaders and diverse teams Competitive base salary Generous paid time off Comprehensive benefits package, including medical, dental, and vision coverage Training, mentorship, and professional development opportunities to grow your career At...
- ...Insurance for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End...
60000 - 90000 Php
...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 position is ideal for those who excel in analytical thinking...- ...Key Responsibilities Review inpatient medical records to validate principal diagnosis, secondary 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...
- ...Conduct audits of clinical appeals to ensure the use of correct appeal letter structure, adherence to the provided guidance/ medical records documentation, and consistency with payor policies and guidelines. Utilize all available tools, including Atlas, Epic, Cleopatra...
- ...knowledge. Key Responsibilities: Clinical Assessment: Conduct comprehensive clinical assessments to determine the patient's medical condition, healthcare needs, and treatment options. Patient Advocacy: Serve as an advocate for patients by ensuring they receive...
- Job Responsibilities: • Negotiation and relationship building with amid and high level managers of hospitals • Evaluation of market trends to drive and maintain sales opportunities • Participation in government biddings • Facilitation/Conduct of product promotion and...
Ritegroup Incorporated
Cebu7 days ago - ...Insurance for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End...
- ...the interpreter’s code of conduct Be aware of the specific vocabulary of the industry the interpreter works with (healthcare and medical, specifically) Go into internal professional training Communicate and report to your team leader *Based on your location,...
- ...automotive leaders and diverse teams Competitive base salary Generous paid time off Comprehensive benefits package, including medical, dental, and vision coverage Training, mentorship, and professional development opportunities to grow your career At...
- ...for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party...
- ...Health & Wellness — Covered: You get comprehensive HMO coverage with a top provider so you can focus on work without worrying about medical bills. Security for the “What Ifs”: Our Group Life Insurance benefit gives you added protection — because your future (and...
- ...for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party...
- ...for you and one free dependent from day one (with the option to enroll additional dependents) Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary) Employee Engagement Activities: Year-End Party...
- ...for you and one free dependent from day one (with the option to enroll additional dependents). Paid Leaves: Birthday, Vacation, Medical, and Maternity (up to 6 Vacation Leaves are convertible to cash on your anniversary). Employee Engagement Activities: Year-End Party...
