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Keywords: Clinical Appeals Specialist, Location: Philippines

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Clinical Denials & Appeals Nurse Specialist

Discover your 100% YOU with MicroSourcing! Position: Clinical Denials & Appeals Nurse Specialist - IP & OP Location... creates sustainable results for the organizations they serve. Your Role The Clinical Denials and Appeals Nurse Specialist (IP...

Posted Date: 22 Jan 2026

Clinical Appeals Specialist

, Apply TODAY! We are hiring for Clinical Appeals Specialist What's in it for you Competitive Compensation Monthly Allowance & Perfect Attendance...: The Clinical Appeals is responsible for performing audits of medical records on behalf of hospital clients to support...

Location: Philippines
Posted Date: 24 Dec 2025

DRG Appeals Specialist

), procedures, and DRG assignment. Analyze payer denials involving: o DRG downgrades o Removal of CC/MCC o Clinical... standards. Collaborate with clinical reviewers, CDI teams, and revenue cycle leadership to resolve complex cases. Ensure...

Location: Cebu
Posted Date: 16 Jan 2026

DRG Appeals Specialist

), procedures, and DRG assignment. Analyze payer denials involving: o DRG downgrades o Removal of CC/MCC o Clinical validation... standards Collaborate with clinical reviewers, CDI teams, and revenue cycle leadership to resolve complex cases Ensure...

Posted Date: 16 Jan 2026

Clinical Quality Auditor

as a Clinical Appeals Specialist for at least 1 year (internal applicants only) Bachelor’s of Science in Nursing (or equivalent... ensure the integrity and quality of our clinical appeals. As an internal team member, you'll have the advantage of already...

Posted Date: 21 Nov 2025

Clinical Quality Auditor

as a Clinical Appeals Specialist for at least 1 year (internal applicants only) Bachelor’s of Science in Nursing (or equivalent... ensure the integrity and quality of our clinical appeals. As an internal team member, you'll have the advantage of already...

Location: Cebu
Posted Date: 20 Nov 2025

Healthcare Specialist

Job Title RCM Specialists & Team Lead - Multiple Openings RCM Blended Specialist Senior RCM Specialist (CDI / UM Focus...) Team Lead - RCM Blended Specialist Overview We are hiring experienced Revenue Cycle Management (RCM) professionals...

Location: Philippines
Posted Date: 02 Feb 2026

RCM Blended Specialist

Role : RCM Blended Specialist Experience : 2-4 years in RCM (physician groups, hospital billing, or healthcare BPO... : Muntinlupa, Philippines We at Coforge are hiring RCM Blended Specialist with the following skillset: Charge Capture for Physician...

Location: Philippines
Posted Date: 24 Jan 2026

Medical Billing Specialist (Home-based)

operations and process improvement efforts. We are looking for a reliable, detail-oriented Medical Billing Specialist who thrives... payment plans. Coordinates and resolves denials including the appeals process. Processes changes in systems to support...

Location: Philippines
Posted Date: 07 Jan 2026

Insurance Verification & Authorization Specialist - Virtual Assistant

This is a remote position. Virtual Rockstar is hiring a full-time Insurance Verification & Authorization Specialist..., referrals, and benefit caps. Clearly document benefits so the clinical/admin team can interpret the information without...

Location: Philippines
Posted Date: 06 Jan 2026

USRN QUALITY ASSURANCE SPECIALIST

on Medicare Part C Appeals At least 1 year to 2 years experience as a Quality Assurance or Quality Evaluator in a clinical BPO...Job Title: USRN Quality Assurance Specialist Shift: Night shift Work Set-up: On-site in Bridgetowne, Quezon City Start...

Posted Date: 01 Jan 2026

Billing Denials Management Specialist

Billing Denials Management Specialist Location: Remote Department: Billing Reports To: Denial Billing Team Lad...: The Billing Denials Management Specialist plays a critical role in the revenue cycle by investigating, resolving...

Company: RML-PH
Location: Philippines
Posted Date: 31 Dec 2025
Salary: 35000 - 40000 per month

RCM Specialist

Explanation of Benefits (EOB), Remittance Advices (RA), and denial codes to determine the root cause of non-payment. Appeals... Management: Prepare and submit well-researched, customized appeals to payers for denied claims (e.g., medical necessity, lack...

Company: Infinit-O
Posted Date: 29 Jan 2026

Medical Coder

Classification of Diseases, Clinical Modification American Health Information Management Association (AHIMA) Standards of Ethical... indicators. Review Inpatient health record documentation, as part of the coding process, to assess the presence of clinical...

Posted Date: 22 Jan 2026

Medical Coder

Classification of Diseases, Clinical Modification American Health Information Management Association (AHIMA) Standards of Ethical... indicators. Review Inpatient health record documentation, as part of the coding process, to assess the presence of clinical...

Posted Date: 22 Jan 2026

Medical Coder

Classification of Diseases, Clinical Modification American Health Information Management Association (AHIMA) Standards of Ethical... indicators. Review Inpatient health record documentation, as part of the coding process, to assess the presence of clinical...

Posted Date: 22 Jan 2026

Medical Coder l 120k SOB

Classification of Diseases, Clinical Modification American Health Information Management Association (AHIMA) Standards of Ethical... indicators. Review Inpatient health record documentation, as part of the coding process, to assess the presence of clinical...

Posted Date: 22 Jan 2026

Customer Support Coordinator

, pre-approvals and appeals Undertake preliminary appeal investigations for specialist review Assist with data input... in a relevant nursing and allied medicine field Clinical medical experience is an advantage Key Responsibilities...

Location: Central Luzon
Posted Date: 17 Jan 2026