行业：Healthcare
职位：Practitioner / Medical Asst
部门：
人数：若干
性质：Full Time
性别：Male
婚姻：No marital status restrictions
学历：Open to all levels
经验：不限
年龄：18岁以上
待遇：₱ 30000-40000PHP/月
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