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Optum

Clinical Appeals Consultant

Optum

Posted

3 weeks ago

Makati, National Capital Region

Remote

PHP 50K

Mid Level

Full Time

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Sema Summary

As a Clinical Appeals Consultant at Optum, you will play a key role in managing medical appeals processes. This full-time position offers a hybrid work environment in the thriving region of Makati, Philippines. The position requires considerable expertise in internal medicine, along with mid-level experience in clinical consulting. You'll support essential healthcare decision-making while collaborating closely with your team. Despite lacking specific benefits and salary details, the role promises a competitive wage and a professional growth opportunity.

About Company

Optum is a health services and innovation company dedicated to helping people live healthier lives. They focus on improving healthcare delivery and accessibility through technology and expert solutions.

Core Requirements

  • Medical Doctor
  • Internal Medicine
  • Clinical Appeal Expertise
  • Consulting Experience
  • Problem-Solving Skills

Responsibilities

  • Manage medical appeals
  • Review clinical documentation
  • Communicate with healthcare providers
  • Ensure compliance with regulations
  • Collaborate with interdisciplinary teams
  • Provide insights for clinical decisions
  • Assist in claim audits

Must Have skills

Medical KnowledgeAnalytical SkillsCommunicationDetail-orientedConsultation Skills

Nice To Have Skills

Team CollaborationTime ManagementResearch SkillsTechnical ProficiencyPatient Advocacy

Job Keywords

Clinical AppealsMedical DoctorHealthcare ConsultingInternal MedicineClaims Management

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