Us Registered Nurse - Usrn - Work From Home Setup

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 :

Supplemental pay types :