MiraMed Philippines Group LLC-Philippines Branch




Job Vacancy: Clinical Denial Specialist


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Why MiraMed?

  • Competitive salary and benefits package
  • Free meal and snacks for every shift
  • HMO extended to dependents

Clinical Denial Specialist reviews the clinical documentation comprehensively. Writes effective appeal using pertinent and relevant clinical documentation from the medical record which is compliant with industry clinical guidelines.

  • Performs medical record reviews retrospectively and be able to determine why cases are denied and whether an appeal is required. Able to review clinical denials in a timely manner and appropriately utilizing clinical criteria sets.
  • Able to think critically and able to use clinical judgment in providing effective and well-supported appeals.
  • Maintains thorough and current knowledge in clinical expertise and stay relevant to in the fast changing trends in healthcare, reimbursement methodologies and utilization.
  • Able to read and understand medical abstract information from handwritten to type written medical record.
  • Able to observe specific payer guidelines for appeal submission and ensures compliance to law and regulations.

Required Qualifications:

  • Must have an active PRC nursing license
  • Preferably with two (2) years of clinical experience
  • BPO experience specifically in healthcare information management account is a plus
  • Excellent English communication skills
  • Willing to work full-time with shifting schedule
  • Willing to work in Ortigas

MiraMed Philippines takes your job application seriously. We offer 1-Day recruitment process. No interview invite received within 24 hours? Visit our Human Resources Office at the 15th Floor of One Corporate Centre along Meralco Ave corner Julia Vargas Ave Ortigas Center, Pasig City Mondays to Fridays from 9:00am to 4:00pm. Join the pioneer in Medical Coding here in the Philippines.

  • Work Experience: 1 year/s
  • Salary: ₱18,000 - ₱22,000
  • Women
  • Balikbayans/OFW Returnees

Required Qualifications:

  • Must have an active PRC nursing license
  • Preferably with two (2) years of clinical experience
  • BPO experience specifically in healthcare information management account is a plus
  • Excellent English communication skills
  • Willing to work full-time with shifting schedule
  • Willing to work in Ortigas

MiraMed Philippines  takes your job application seriously. We offer 1-Day recruitment process. No interview invite received within 24 hours? Visit our Human Resources Office at the 15th Floor of One Corporate Centre along Meralco Ave corner Julia Vargas Ave Ortigas Center, Pasig City Mondays to Fridays from 9:00am to 4:00pm. Join the pioneer in Medical Coding here in the Philippines.

MiraMed Philippines  takes your job application seriously. We offer 1-Day recruitment process. No interview invite received within 24 hours? Visit our Human Resources Office at the 15th Floor of One Corporate Centre along Meralco Ave corner Julia Vargas Ave Ortigas Center, Pasig City Mondays to Fridays from 9:00am to 4:00pm. Join the pioneer in Medical Coding here in the Philippines.