As a Clinical Appeals Nurse, you will be responsible for reviewing denied or disputed insurance claims and medical bills to ensure proper reimbursement for healthcare services rendered. Your role involves advocating on behalf of patients and healthcare providers to appeal denied claims and secure fair coverage from insurance companies or other payers. You will utilize your clinical expertise to assess medical records, treatment plans, and insurance policies to determine the validity of appeals.
Qualifications:
- Philippine Registered Nurse
- Clinical Appeals Experience
- Utilization Management Experience (BPO)
Job Types: Full-time, Permanent
Pay: Up to Php71,
- 00 per month
Benefits: - Paid training
Schedule:
* 8 hour shift
