Clinical Denials & Appeals Nurse Specialist (IP & OP)
TalentBuzz Recruitment Agency
On-site - Taguig 3-5 Yrs Exp Bachelor Full-time
Job Description
Employee Recognition and Rewards
- Commission
- Performance Bonus
Insurance Health & Wellness
Professional Development
- Maternity & Paternity Leave
- Sick Leave
- Vacation Leave
- Review and analyze clinical denial cases related to inpatient and outpatient services.
- Prepare and submit comprehensive appeals for denied claims to insurance providers.
- Collaborate with medical staff to gather necessary documentation and resolve billing issues.
- Stay updated on clinical guidelines and payer policies to effectively manage appeals.
- Provide education and training to nursing staff on denial prevention strategies.
Req...