Global StarterNational Capital Region, Philippines
18 days ago
Job description
Qualifications :
USRN - "Active US and PH Nurse License
USRN license should be registered in main land state.
At least one (1) year of clinical experience is preferred
Experience in Healthcare Utilization Review / Utilization Management with focus in Precertification review.
Knowledge on federal, state, URAC, and client protocols is preferred.
Must be amenable to work either in Taguig / Quezon City / Cebu
Willingness to work on night shift.
100k joining bonus, terms and conditions apply.
Job Description
Determine customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented.
Assess medical appropriateness of claims submitted, and adjust claims as needed.
Pay all covered claims accurately and timely.
Manage both new claims and open claims equally and maintains decision turnaround times.
Understand the client's operations and corporate compliance, policies and procedures and best practices
Salary
Php22,000.00 - Php60,000.00 per month
Benefits
Paid training
Work from home
Schedule :
10 hour shift
8 hour shift
Supplemental pay types :
13th month salary
Overtime pay
Performance bonus
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Us Registered Nurse • National Capital Region, Philippines