Medical Care Specialist

2 days ago

Manila, National Capital Region, Philippines beBeeWoundcare Full time ₱350,000 - ₱450,000
Job Description:

As a Medical Reviewer, you will manage patient wound care records, verify insurance eligibility, and coordinate the supply of essential medical materials. Your primary responsibility will be to ensure that patients receive timely and quality wound care services.

">Key Responsibilities:
  • Manage patient wound care records and progress reports
  • Pull reports and documents for patients with wounds
  • Communicate with Payer teams to determine insurance eligibility and assess Medicare medical necessity guidelines
  • Store and organize clinical details, dispensing orders, and documents effectively
  • Enter patient, wound, and dressing data into wound orders and spreadsheets
  • Validate medical necessity for existing orders and document changes accurately
  • Collaborate with staff at homes for clarifications or timeline requirements
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

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