Location
taguig, metro manila, Philippines
Posted
July 27, 2026
Job Description
Utilization Review Nurse
- Taguig, Metro Manila, Philippines
- Full-Time
- On-Site
- Night shift
- 61,000-75,000 PHP / Month
Your Role
The Clinical Denials and Appeals Nurse Specialist (IP & OP) is responsible for reviewing the claims denied and carrying out the appeals process appropriately and in a timely manner. This individual identifies and works denials, responding to the denial reason and resubmitting any information needed to the payor. The Clinical Denials and Appeals Specialist should be knowledgeable of U.S. state/federal laws that relate to payor contracts and to the appeals process. This role requires frequent and effective communication via phone, email, and instant messaging with the various engagement teams. Strong oral and written communication skills, analytical skills, ability to work independently, and be self-motivated are required.
Denials and Appeals Management
- W...