Clinical Appeals - Quality Analyst PHRN/USRN (Temporary WFH)
Pasig, National Capital Region
Posted 5 days ago
- Company:
- TASQ Staffing Solutions
- Company Description:
- Founded by experts with more than 70 years of collective experience in the staffing solutions industry, TASQ understands the unique challenges in the talent acquisition space and is committed to being the trusted partner of companies in their pursuit of hiring the best people to fill their manpower needs. Composed of highly skilled team members who have worked with organizations ranging from small-to-medium entities to large-scale enterprises (including Fortune 500 companies), TASQ is fully capable of meeting staffing demands at all levels and across different industries. Talent Acquisition delivered with Speed and Quality that's the TASQ guarantee!
- Contract Type:
- Full Time
- Experience Required:
- 1 year
- Education Level:
- Bachelor’s Degree
- Gender:
- Any
- Number of vacancies:
- 1
Job Description
Non-negotiable Qualifications:
Must have an active PHRN/USRN license
Must have at least 1 year of QA experience in Clinical Appeals in a BPO or hospital setting (utilization review acceptable for PHRNs)
Knowledgeable in medical terminology, anatomy, and physiology
With experience in reviewing pre/post-service denials, medical necessity reviews, and completing appeals and/or coordinating peer-to-peer reviews.
Understanding of healthcare regulations and compliance
Excellent English comms skills
Fast and stable internet connection - at least 50 Mbps
Willing to work the night shift
Amenable to work on a temporary WFH setup (Pasig - Must be residing within Metro Manila or near area)