Clinical Authorization Nurse
AGS Health Taguig Full-time
Qualifications
- Active PHRN license
- Prior experience as a Clinical Authorization Nurse in a BPO healthcare setting
- Knowledge of MCG/InterQual (preferred)
- Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
- Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
- Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.
- Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
- Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial.
- Prioritize the incoming authorizations by level of urgency to the patient.
- Manage correspondence with insurance companies, physicians, specialists, and patients as needed, including documenting in the EHR as appropriate.
- Respond to clinical questions regarding payer medical policy guidelines
AdminEdgeManila, 12 km from Taguig
Position: Virtual RN – Chronic Care & Clinical Operations Specialist
Job Type: Part-time (20 hours/week)
Location: Philippines (Remote, US hours)
Salary: $7 - $8 per hour
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AYUDA Business Management Solutions IncTaguig
Job Description
URGENT HIRING: Clinical Denials & Appeals Nurse (RN / USRN)
Salary: Up to PHP 75,000 (MAX) monthly
Location: Bonifacio Global City (BGC), Taguig
Schedule: Full Onsite | Night Shift
Job Overview
We are urgently looking...
Cardinal HealthTaguig
What Clinical Research contributes to Cardinal Health
Research is responsible for the development of new and improved products through initiating, designing, developing and executing research and product development projects.
Clinical Research...