Company Description
Access Healthcare, established in 2011, is a global leader in healthcare management and revenue cycle management (RCM) solutions. The organization leverages innovative technology, workflow automation, and healthcare expertise to enhance operational efficiency and elevate patient care. With a global presence spanning 24 delivery centers across the US, UK, India, and the Philippines, Access Healthcare employs over 27,000 revenue cycle professionals. The company is dedicated to improving the financial and operational performance of healthcare providers while maintaining transparency and scalability for its clients.
Role Description
This is a full-time, on-site PHRN Clinical Denials role located in Metro Manila. Responsibilities include reviewing and analyzing clinical documentation to manage and process denials effectively, conducting research related to denied claims, and providing insights into improving denial rates. The role also involves collaborating with cross-functional teams to ensure compliance with medical policies and optimizing the resolution of clinical denials. Ongoing training and staying updated with healthcare guidelines will also be a significant part of the role.
Qualifications
- Strong skills in Communication to effectively collaborate, explain denials, and provide guidance on medical policy-related matters.
- Knowledge of Medicine and Clinical Research to review clinical documentation and ensure compliance with healthcare guidelines.
- Experience in Training and Research to stay updated on denial trends and educate team members or stakeholders as needed.
- Ability to analyze and solve complex issues related to denials while maintaining a detail-oriented and process-driven approach.
- Registered Nurse (PHRN) license is required.
- Familiarity with revenue cycle management, medical documentation, and healthcare regulations is an advantage.
