Skip to content
CV Rocket
Get started
How it worksThe enginePricingBlogContactSign in

Open nowFirst seen 4 days ago

Clinical Denial Appeals

PM Consulting1,477 open roles

Where
Taguig, Metro Manila, Philippines, Philippines
Get the CV for this job

From $25 per CV, paid once. No subscription.

Your applicationOpen nowClinical Denial AppealsPM Consulting · Taguig, Metro Manila, Philippines, Philippines

  1. YouYes, apply to this one.

  2. CV RocketCV written for this posting.

  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

  4. CV RocketApplied on PM Consulting's own form.

The reply lands in your private mailbox

3×more interviews than doing it yourself with ChatGPT.

The clock on this job

Early applications get read.

12.3% of postings close within 7 days. Measured by our own scanner across the market. PM Consulting postings stay open a median of 1 days.

Share of postings closed within
  1. 2.1%1 day
  2. 4.5%3 days
  3. 12.3%7 days
  4. 19.3%14 days
  5. 35.6%30 days
  6. 57.8%60 days
This job: first seen 4 days ago

PM Consulting median: 1 days open

The posting

Job description:

Key Responsibilities:

Denials and Appeals Management:

  • Review and evaluate denied claims, including payer policies and clinical documentation
  • Submit retro-authorizations in response to authorization denials
  • Conduct medical necessity reviews and prepare supporting clinical summaries
  • Write and submit detailed, well-supported appeals based on clinical documentation and payer guidelines
  • Track, document, and follow up on all appeals through resolution
  • Maintain accurate and timely communication with payers and internal stakeholders
  • Perform research to support appeals and stay updated on payer policies and best practices

Tracking, Reporting, and Trends:

  • Monitor and analyze denial trends and root causes
  • Escalate patterns and issues to management with recommendations
  • Assist in preparing and maintaining reports related to denials and appeals
  • Collaborate with teams to improve processes and reduce A/R

Compliance and Continuous Improvement:

  • Ensure compliance with HIPAA, company policies, and regulatory requirements
  • Identify and report billing discrepancies and compliance risks
  • Participate in process improvement and system enhancement initiatives
  • Engage in ongoing professional development and training

Qualifications:

Required:

  • At least 1 year of clinical appeals writing experience
  • 3–5 years of acute care clinical experience in a hospital setting (2–3 years if ICU)
  • Bachelor of Science in Nursing (BSN)
  • Active PHRN or USRN license
  • Strong knowledge of U.S. healthcare systems, insurance regulations, and RCM processes
  • Proficiency in InterQual or MCG clinical guidelines
  • Experience with EMR systems such as Epic, Cerner, or Meditech
  • Excellent verbal and written English communication skills (minimum CEFR B2)
From $25, paid onceGet the CV for this job

What happens when you press

One press. We do the rest.

  1. A CV for this posting

    Written against PM Consulting's own wording, from every piece of relevant proof in your profile.

  2. 25 readers review it

    Recruiter, hiring manager, skeptic and more read every draft, round after round. You get the best round.

    The review screen in CV Rocket: how each CV was read, round by round.

  3. We apply on PM Consulting's form

    Our application engine gets through the hardest forms there are. Where a question needs you, AI suggests the best answer. Don't want us applying from our IP addresses? Use our Chrome extension: we apply straight from your own browser.

    An application in CV Rocket: every answer filled in on the employer's form.

  4. Every reply, sorted

    PM Consulting's answer lands in your private mailbox, and we classify it on arrival: interview, question, rejection.

    The CV Rocket inbox: each employer reply classified as an interview, an action or a rejection.

  5. Reply with AI

    AI helps you write the email, checks it and sends it. We show you whether the recruiter read it.

  6. The interview in your calendar

    Full integration with your calendar. The invitation goes straight in.

    An interview invitation in the CV Rocket inbox, added to the candidate's calendar.
Get the CV for this job

From $25 per CV, paid once. No subscription.

Why it works

3×

more interviews than doing it yourself with ChatGPT.

ChatGPT writes a CV and never learns what happened to it. We see every reply. For each CV we know:

  • How it was written, and how the review scored it
  • When we applied, and how long after the posting went up
  • Which posting, which company, which city
  • Who got the interview, and who heard nothing

That is how we know which CVs get called.

Get the CV for this job

From $25 per CV, paid once. No subscription.

The numbers game

More applications. More interviews.

Every application goes out with its own CV, written for that posting and paid once. Send enough of them and the law of large numbers finds you the job.

Get the CV for this job
By hand5–10
With CV Rocket100
applications a day

Nearby

Live postings like this one

Same employer first, then the same role elsewhere.

Before you press

Straight answers

Get the CV for this job

From $25 per CV, paid once. No subscription.

What if my background isn't good enough?

We make the most of the background you have. The CV uses every piece of relevant proof your profile holds, and one of the 25 readers reads your whole profile and flags what the CV left out.

Do you really apply for me?

Yes, on the employer's own form, the hardest ones included. Where a question needs you, you answer it right there and AI suggests the best answer. Don't want us applying from our IP addresses? Use our Chrome extension: we apply straight from your own browser.

Is it a subscription?

No. You pay once per CV, from $25. Every application goes out with its own CV, written for that posting.

One job. One CV.
Paid once.

Pick the posting you want. We write for it, apply for you and catch the reply.

Get the CV for this job

From $25 per CV, paid once. No subscription.