Clinical Denials/Appeals Nurse (In-Patient and Out-Patient)

• Collaborate with healthcare providers to gather necessary documentation for appeals.
• Ensure compliance with industry regulations and organizational policies.
• Maintain accurate records of denials and appeals for reporting purposes.
• Participate in training sessions to stay updated on healthcare industry standards.
• Identify trends in denials and provide recommendations for process improvement.
• Work closely with cross-functional teams to resolve complex cases effectively.

Join a company with a team-oriented culture.Gain access to structured trainings for continuous career growth.

A successful Clinical Denials & Appeals Nurse Specialist (In-Patient and Out-patient) should have the following non-negotiable requirements:

1. 12 whole months of clinical appeals writing experience
2. Hospital bedside experience: either 3-5 years acute care (Med/Surg) or 2-3 years ICU experience
3. Active nursing license, either a PHRN or USRN license
4. Must be willing to work fully on-site at BGC, with a Philippine night shift.

• Monthly gross up to PHP 75,000
• Day 1 HMO with 200k MBL with 2 dependents
• Paid Time Off
• Group Life Insurance
• License/Certification renewals shouldered by the company