Medical Wound Care Specialist

1 day ago

Antipolo City, Calabarzon, Philippines beBeeWoundCare Full time ₱30,000 - ₱50,000
Job Title: Medical Reviewer

The Role:

We are seeking a skilled medical professional with expertise in wound care to manage patient wound care records, verify insurance eligibility, and coordinate the supply of essential medical materials.

Key Responsibilities:
  1. Manage records progress for wound care intake
  2. Pull reports and documents for patients who are at home with wounds at time of review
  3. Communicate with the payer team to determine which patients have insurance eligibility
  4. Assess which wounds are eligible for supplies under Medicare medical necessity guidelines
  5. Store and effectively organize records of clinical details, dispensing orders, and documents
  6. Enter patient, wound, and dressing data into wound orders and onto spreadsheets
  7. Add product specifics to spreadsheets, support product verification steps to prepare orders including sizes, quantities, preferred brands
  8. Validate medical necessity for existing orders, document changes accurately
  9. Communicate via email and phone with staff at homes, clarifications on clinical questions or timeline on order signatures required for delivery date
  10. Collaborate with the clinical review team in other service lines may be required
  11. Track communication and findings within the company system
  12. Provide support for tracking systems, IT, and spreadsheet tools for chart reviews and order preparation
  13. Support streamlining communication and workflow with resources available
  14. Maintain working knowledge and tracking of product billing and reimbursement data
  15. Conduct research on comparable products and their pricing

Requirements:

  • 2+ years of clinical wound care experience preferred
  • Diploma/ Degree in Nursing, Medicine or related field
  • Excellent English communication skills, both verbal and written
  • Ability to work in a fast-paced environment
  • Strong critical thinking and customer service skills
  • Knowledge of eligibility, Medicare and product guidelines for education sessions i.e., Noridian LCD

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