Clinical Denials & Appeals Nurse Specialist (IP & OP), Taguig

• 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.

• Educational Qualifications: Bachelors degree in Nursing or a related field
• Experience Level: 3-5 years of experience in clinical nursing or related field
• Skills and Competencies: Strong analytical skills and attention to detail
• Skills and Competencies: Excellent communication and interpersonal skills
• Qualities and Traits: Ability to work independently and collaboratively in a team environment
• Responsibilities and Duties: Knowledge of healthcare billing and coding processes

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