- Manages incoming or outgoing telephone calls, emails, and/or faxes, including triage, 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 claimant or other supporting systems, emails and/or from fax.
- Manages claims, collection of non-clinical information needed for review from claimants and providers, utilizing scripts to screen basic and complex requests.
Graduate of Bachelor’s Degree in Nursing • Holds active and unrestricted local (PH) Registered Nurse license • Must have at least 3 months experience as a Registered Nurse in a clinical setting • Experience in a front-office (voice) call center or BPO back-office environment is an advantage • Knowledge of ICD-9 and ICD-10 and CPT codes is an advantage
Vacancy Type: Full Time
Job Location: Manila, PH
Application Deadline: N/A