Philippines Job Openings
Access Healthcare
PHRN Auditor | Nurse Auditor ( Healthcare BPO )
Taguig
FULL TIME
September 1, 2024
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
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
- 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
Pay: Php35,000.00 - Php45,000.00 per month
Benefits:
- Health insurance
- Life insurance
- Paid training
- Pay raise
- Promotion to permanent employee
- Monday to Friday
- Night shift
- 13th month salary
- Yearly bonus
- Taguig City: Reliably commute or planning to relocate before starting work (Required)
- Active CPC License (Preferred)
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