Medical Review Jobs

MetHealth - Eastwood City, Quezon

• Partner with healthcare providers to ensure optimal member outcomes and maximize benefits for patients. • Oversee the initial benefit determinations and medical necessity reviews, ensuring 35000

from: jobslin.com - 8 days ago

QuickStart Careers - Pasig

, adaptability, and a strong command of the English language (C1 level or higher). Key Responsibilities Create, review, and maintain scientific and technical documentation related to dental and medical products

from: bossjob.ph - 4 days ago

MetHealth - Eastwood City, Quezon

• Collaborate with the Medical Director to review cases that do not meet medical necessity standards. • Ensure that all written communication to providers and members is accurate and timely, in line 35000

from: jobslin.com - 8 days ago

MetHealth - Eastwood City, Quezon

for approval or denial, and forward cases to the Medical Director for final review. Review medical claims to verify medical necessity based on established guidelines. • Interpret customer needs and assess 35000

from: jobslin.com - 8 days ago

Optum - Pasig

). Performs reviews of current inpatient services. Determines medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination. *Employees

from: bossjob.ph - 8 days ago

MetHealth - Eastwood City, Quezon

• Escalate complex cases to appropriate departments for resolution. • Stay updated on industry trends and medical policies. • Assist in policy development for medical claim reviews. 35000

from: jobslin.com - 7 days ago

ActiveOne Health - Makati

be appropriately revised or removed. Conduct periodic examinations of employees in designated medical monitoring programs; through health data analysis.promotion and disease prevention. Review results of medical

from: bossjob.ph - 8 days ago

Genfinity - Makati

) and determine appropriateness of treatment and length of treatment. Determine appropriateness of referrals to peer advisors. Maintain and monitor volume and cost of peer advisor reviews for management report

from: bossjob.ph - 9 days ago

Manpower Core Group Inc. - Taguig City, National Capital Region

(PRC) License. Must be an AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC). At least 5 years of experience in the areas of CPT Coding, Medical Billing 65000

from: jobslin.com - More than 30 days ago

UERMMMC - Quezon City

Job Description : Performs and/or assists in the performance of tasks such as but not limited to the following: Review medical history, orient and prepare patients for procedure; Performs technical

from: bossjob.ph - 7 days ago