Job Description

Accesshealthcare is looking for Registered Nurses and Medical Allied Graduates to join our growing team.

You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.

Medical Allied:

• Will need to complete a full analysis of patient’s medical charts
• Conduct outbound calls to providers to obtain authorization of specific medical procedure or prescription drug and to check on patient’s eligibility, benefits, and coverage
• Document the call notes and take appropriate action on the revenue cycle system
• Communicate with insurance payers to deliver supporting clinical and confidently speak with nurse reviewers to discuss patient’s conditions

Registered Nurses:

• Perform advanced level work related to clinical denial and utilization management.
• Manage medical denials by conducting a comprehensive review of clinical documentation.
• Handle audit/compliance responsibilities and other administrative duties as required.
• Write compelling arguments based on the clinical documentation and the medical policies of the payer and submit appeals in a timely manner.
• Resolve charge problems to ensure accurate and complete billing, and inform staff on proper billing, follow-up, and documentation practices.
• Review and rectify errors in third party payer reimbursement denials based on documentation, billing accuracy, medical necessity, coding, modifier, and other related issues.
• Actively manage, maintain, and communicate denial or appeal activity to appropriate stakeholders and report suspected or emerging trends related to payer denials to Revenue Cycle management.

Qualifications

• Must be Registered Nurse with Active license
• College Graduates of Medical allied courses, please find below:
  • Nursing, Medicine, Physical Therapy, Occupational Therapy, Pharmacy, Medical Science, Human Medical, Science, Medical Technology, Medical Laboratory, Science Nutrition, Dietetics, Respiratory Therapy, Radiological Technology, Biology, Microbiology, Human Biology, Registered Midwife and other related medical allied courses
• Experience in BPO Healthcare account is definite advantage (Insurance, Denials, Appeals, Coding, Prior Authorization, Utilization)
• Willing to work onsite at McKinley, Taguig
• Can start ASAP!

What's in it for you:

• Annual Salary Increase (based on performance)
• 20% Night Differential Pay
• HMO on Day 1
• Life Insurance on Day 1
• 25 Leaves per year
• Free Shuttle

How to apply:

• Submit your CV / Email: PH_TA_TEAM@accesshealthcare.com
• Walk-in and apply: Monday to Friday, 9AM - 6PM at Sixth Floor, One World Square, Upper Mckinley, BGC, Taguig
• Reach out via sms: to 09169425549

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Qualification Required

• College Graduate