Wound Care Specialist

1 day ago

Pulong Santa Cruz, Calabarzon, Philippines beBeeWound Full time ₱52,000 - ₱68,000

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

The Opportunity:

This role is ideal for a skilled Medical Reviewer with a focus on wound care. You will work remotely in a fast-paced environment and collaborate with an international team.

In this position, you'll be responsible for managing patient wound care records, verifying insurance eligibility and coordinating 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.

  • Manage patient wound care records
  • Verify insurance eligibility
  • Coordinate the supply of essential medical materials
Your responsibilities will include:
  • Responsible for records 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 and assess which wounds are eligible for supplies under Medicare medical necessity guidelines
  • Store and effectively 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
  • Tracking 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
  • Product research, cost-effective and comparable product resources
To succeed in this role you will need:
  • 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
Benefits:

You will have the opportunity to work from home and enjoy a flexible schedule.

Why choose this role?

This role offers a challenging and rewarding work environment with opportunities for growth and development.

You will have the chance to make a meaningful impact in the lives of patients and contribute to a dynamic and growing healthcare organization.

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