Philippines Job Openings

Access Healthcare

Clinical Auditor | Nurse Auditor | PHRN ( Healthcare BPO )

Taguig

FULL TIME

September 1, 2024

Join Access Healthcare Manila as a Inpatient DRG Nursing Auditor.We are seeking talented individuals to join our team and help drive our success. Apply now and take the next step in your career today.
Job Description:

Conduct initial audit reviews to validate billed diagnoses and DRG code are supported by medical records
Record Audit results and document finding notes based on policies using professional clinical resources
Perform provider appeals reviews and render decision to either uphold or overturn original finding
Review questionable encoder results, complex cases, and appeal reviews to facilitate referrals to clinical department as needed
Propose new audit concepts supported by your research and analysis
Define new audit concept criteria and test and validate new concepts developed by analytics team

Escalate facility issues per client guidance
Qualifications:

Must be Philippine Registered Nurse (with Active license)
Must have an experience in clinical and audit in IP DRG
Good Comprehension and writing skills are required to provide the findings to physician
Curiosity and willingness to ask questions
Strong attention to detail, organized and thorough
Strong verbal and written communication skills
Ability to understand client guidelines related to insurance advantage claims

Benefits:

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

Job Type: Full-time
Pay: Php35,000.00 - Php45,000.00 per month
Benefits:

Health insurance
Life insurance
Paid training
Pay raise
Promotion to permanent employee

Schedule:

Monday to Friday
Night shift

Supplemental Pay:

13th month salary
Yearly bonus

Ability to commute/relocate:

Taguig City: Reliably commute or planning to relocate before starting work (Required)

License/Certification:

Active CPC License (Preferred)

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