Clinical Support Specialist

6 days ago


Ortigas, Philippines The Referrers PH Full time

Company Overview:

The Referrers PH is a leading healthcare organization dedicated to delivering exceptional patient care and support services.

Job Description:

We are seeking an experienced Clinical Support Specialist to join our team. As a key member of our clinical operations, you will play a critical role in ensuring the smooth delivery of patient care services.

Responsibilities:

  • Provide high-quality support to the clinical team and client team members.
  • Determine customer eligibility by reviewing contractual language and medical documentation.
  • Assess medical appropriateness of claims submitted and adjust claims as needed.
  • Process all covered claims accurately and timely.
  • Manage both new claims and open claims equally, maintaining decision turnaround times.

Required Skills and Qualifications:

  • Active license.
  • At least 6 months of hospital experience.
  • 1 year prior authorization experience – negotiable: Healthcare experience.
  • Strong communication and interpersonal skills.
  • Good typing skills.

Benefits:

  • Competitive salary range: $40,000 - $50,000.
  • Opportunity to work with a world-class medical coding staff.


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