Clinical Billing & Reimbursement Nurse I

Crawford & Company; Western Visayas; On-site; PHP 300,000 - 540,000; Full time

Job summary

Crawford & Company in the Philippines is seeking a Medical Bill Review Auditor who will process inpatient and outpatient bills according to SOPs and timelines, with a focus on accuracy and reimbursement determination.

The role requires a Bachelor’s in Nursing and an active Philippine RN license, plus at least 1 year of clinical or medical bill review experience, strong communication, and the ability to work independently within a team.

Qualifications

• Bachelor's degree in Nursing required.
• Active Philippine RN license required.
• Minimum 1 year clinical experience or prior experience in medical bill review or claim/case review.
• Good communication skills.
• Proficient in word processing software applications.

Responsibilities

• Audits inpatient and/or surgical bills following SOPs and turnaround times.
• Performs bill review and uses appropriate resources.
• Clarifies billing discrepancies to analyze and recommend reimbursement.
• Documents information in system bill notes to support determination.
• Performs reconsideration of bills as requested to ensure proper processing.
• Collaborates with peer physicians to determine reimbursement.
• Understands Broadspire policies and communicates them to internal/external customers.

Skills

Communication skills

Analytical skills

Attention to detail

Multitasking

Teamwork

Discretion/Professionalism

Education

Bachelor's degree in Nursing

Philippine RN license

Tools

MS Word

Job description

Crawford & Company in the Philippines is seeking a Medical Bill Review Auditor who will process inpatient and outpatient bills according to SOPs and timelines, with a focus on accuracy and reimbursement determination.

The role requires a Bachelor’s in Nursing and an active Philippine RN license, plus at least 1 year of clinical or medical bill review experience, strong communication, and the ability to work independently within a team.