Registered Nurses for Clinical Appeals Writer
| 行业 | Healthcare | 职位 | Practitioner / Medical Asst |
|---|---|---|---|
| 招聘部门 | 招聘人数 | 若干 | |
| 工作地区 | Metro Manila (NCR)Taguig | 工作性质 | Full Time |
| 性别要求 | Male | 婚姻要求 | No marital status restrictions |
| 学历要求 | Open to all levels | 工作经验 | 不限 |
| 年龄要求 | 18岁以上 | 待遇水平 | 30000-40000PHP/月 |
| 更新日期 | 2022-09-29 | 有效期至 | Valid for a long time |
职位描述
Qualifications:
At least 1 year Clinical (bedside) experienceAt least a year revenue cycle management experiencewith background in Clinical Appeals, InterQual Reviews and MCGWilling to work onsiteWilling to work in BGCShift: 6:00AM-3:00PMResponsibilities and Duties
Performs retrospective (post-discharge/ post-service) medical necessity reviews to determine appellate potential of clinical disputes/denials or those eligible for clinical review.Constructs and documents a succinct and fact based clinical case to support appeal utilizing appropriate module of InterQual® criteria (Acute, Procedures, etc). If clinical review does not meet IQ criteria, other pertinent clinical facts are utilized to support the appeal. Pertinent clinical facts include, but are not limited to, documentation preventing a safe transfer/discharge or documentation of medical necessary services denied for no authorization.Demonstrates ability to critically think, problem solve and make independent decisions supporting the clinical appellate process.Demonstrates proficiency in use of medical necessity criteria sets,MCG and InterQual®, as evidenced by Inter-rater reliability studies and other QA audits.Why join us?
Job Types: Full-time, Permanent Plus, Allowances and 15%-night differentialHMO upon hire plus 1 dependent Additional 2 HMO dependents upon regularization Group life insuranceCOVID-19 considerations: work set up公司介绍
更多A leading fortune 500 Hospital and Healthcare company just opened it's Philippine office in Bonifacio Global City, Taguig. Be part of the pioneer shared services team and make a positive impact to the community.We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community.Our company is a healthcare services company headquartered in Dallas, Texas. We operate 65 hospitals and approximately 500 other healthcare facilities across the US. The company is listed in the NYSE.