Position Overview
About This Role
The PH Registered Nurse Clinical Appeals role involves reviewing and extracting case details from patient medical records and crafting appeal letters according to established guidelines. This position is ideal for experienced nurses with a background in clinical care and coding.
Highlights
- Location: Makati, National Capital Region
- Schedule: Full Time
What You'll Do
- Review and extract pertinent case details from patient medical records.
- Craft strongly defensible appeal letters per process instructions.
- Complete cases within time expectations while providing high-quality reviews.
- Adhere to Optum and OPAS policies and procedures.
- Comply with employment contract terms and company policies.
Requirements
- Education:
- Bachelor's degree in nursing required
- Experience: