Registered Nurse (PHRN) - McKinley, Taguig

Work Setup: Onsite (McKinley Taguig)

Work Schedule: Night/Shifting

Industry: BPO

Start Date: ASAP

Requirements:

1. Active Registered Nurse
2. At least 1 year of BPO Clinical / Healthcare experience or 1 year of Bedside / Hospital Experience
3. Strong communication skills
4. Willing to work onsite in McKinley, Taguig

Responsibilities:

1. Clinical Review & Documentation: Analyzing medical records for accuracy, compliance, and appropriateness of care.
2. Claims Processing: Determining patient eligibility, validating medical claims, and managing insurance coverage.
3. Utilization Management: Reviewing treatment plans against medical policies to ensure cost-effective care.
4. Case Management & Liaison: Communicating with healthcare providers and patients to facilitate care and resolve inquiries.
5. Clinical Training (if applicable): Developing or delivering training programs for healthcare staff.