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Care Management PH RN Voice Analyst

Professional Services Company

Multiple Locations

Hiring until November 09

Refer & Earn

Up to Php 3,000

Job Description

Overall responsibilities:

Claims management for Absence and Disability Insurance:

Gathers info and performs a variety of complex clerical or administrative support functions w/c requires knowledge and understanding of disability policies and processes to appropriately calculate the benefits due. Manages incoming or outgoing telephone calls, emails, and/or faxes, including triage, the opening of cases, and data entry into client system. Determines contract; verifies eligibility and benefits. Adhere to federal and state regulatory and/or client plan requirements and established workflows; Obtains information from the claimant or other supporting systems, emails, and/or from the fax. Manages claims, collection of non-clinical information needed for review from claimants and providers, utilizing scripts to screen basic and complex requests.

Qualifications

Educational Attainment

College Graduate

Min. Work Experience

1 year

Qualification Summary

  •  Holds a current and unrestricted local (PH) Registered Nurse license.
  • Bachelor of Science Nursing (BSN) degree 
  • minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting required
  • Three months is equivalent to 480 hours of working experience as an RN; 
  • Work experience as a Registered Nurse means holding an active RN license and providing direct patient care; 
  • Knowledge of disability claims management process and ability to interpret and apply member contracts, and member benefits; Knowledge of ICD-9 and ICD-10 and CPT codes, preferred;

Skills Required

Customer Service

Communication Skills

Medical Coding

Benefits

HMO
Life Insurance
Company-sponsored training
upskilling
and certification

Job Details

Employment Type

Full-Time

Position Level

Staff

Work Schedule

Amenable to Any Shift

Job Category

Management & Operations

Vacancy

11

About Professional Services Company

A multinational professional services company that provides technology, business, and management consulting services specializing in strategy, operations, technology, digital, and consultation. They service clients from all over the world and have offices located globally, with the Philippine branch comprising of about 50,000 employees.