USRN Opportunity with ₱150,000 Sign-On Bonus | Healthcare Program | Davao

3 weeks ago


Davao del Sur Philippines Sutherland Philippines Full time

Responsibilities

  • Review medical records in relation to the services billed on claims
  • Collaborate with Medical Directors to obtain determinations where medical necessity is unclear
  • Coordinate referrals from non-clinical staff for clinical case reviews
  • Ensure claims adhere to all regulatory requirements before final processing
  • Handoff cases back to non-clinical staff for letter creation and claim adjustments
Qualifications
  • Must be a college graduate
  • Active license or certification for USRN
  • Basic knowledge of troubleshooting and computer navigation
  • Background in clinical review or medical claims processing
  • Willing to work onsite
  • Must be residing in DAVAO
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