Clinical Wound Care Specialist

7 days ago

Dasmariñas, Calabarzon, Philippines beBeeWoundCare Full time ₱800,000 - ₱1,200,000

At a leading healthcare organization, we specialize in recruiting and managing high-caliber staff for dynamic and growing facilities. Leveraging our extensive network, we connect clients with highly qualified professionals, offering tailored services to meet their unique needs.

The Opportunity:

We are seeking an experienced Medical Reviewer to join our team In this role, you'll manage patient wound care records, verify insurance eligibility, and coordinate the supply of essential medical materials. Your expertise in meticulous documentation and effective communication will play a crucial role in ensuring patients receive the care they need.

This position is remote and offers flexibility in working from home.

Your responsibilities will include:
  • Manage progress for wound care intake
  • Pull reports and documents for patients who are at home with wounds at time of review
  • Communicate with the Payer team to determine which patients have insurance eligibility
    Assess which wounds are eligible for supplies under Medicare medical necessity guidelines
  • Store and organize records of clinical details, dispensing orders, and documents
  • Enter patient, wound, and dressing data into wound orders and onto spreadsheets
  • Add product specifics to spreadsheets, support product verification steps to prepare orders including sizes, quantities, preferred brands
  • Validate medical necessity for existing orders, document changes accurately
  • Communicate via email and phone with staff at homes, clarifications on clinical questions or timeline on order signatures required for delivery date
  • Collaborate with the clinical review team in other service lines may be required
  • Track communication and findings within the company system
  • Provide support for tracking systems, IT, and spreadsheet tools for chart reviews and order preparation
  • Support streamlining communication and workflow with resources available
  • Maintain working knowledge and tracking of product billing and reimbursement data
  • Research, cost-effective and comparable product resources
To succeed in this role you will need:
  • 2+ years of clinical wound care experience
  • 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.
Benefits:

Remote work arrangement offering flexibility and convenience.

Why This Role?

You will collaborate with an international team while contributing to a growing business, all from the comfort of your home.

Requirements:

A reliable computer, noise-canceling headset, a second monitor for enhanced productivity, and a stable internet connection.

This is an excellent opportunity to make a meaningful impact and advance your career in wound care management.

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