Case Manager

  • Critical Skills: 

    At least 2 years BPO experience handling a US Healthcare account is required
  • Location: Makati
  • Salary: Php 25,000 – Php 30,000

Job Description

  • Will handle all cases under Commercial HMO, Medicare HMO, Medicaid HMO (Subacute Leveled Residents) and Workers Compensation.
  • Will communicate with Insurance Case Managers, submit notes for concurrent review and ensure that we are getting higher levels and carve outs for high cost medications and for patients receiving moderate to complex medical and nursing intervention.
  • Will be part of the Interdisciplinary Team and will also join UR Meetings to discuss discharge plans for the members.
  • Will also handle denials and appeals. The goal is to extend patient stay and get high level of care or treatment deemed as appropriate.

QUALIFICATION

  • Must be a Licensed RN or Graduate of a Medical Allied course
  • At least 2 years BPO experience handling a US Healthcare account is required
  • Basic knowledge of Medicare/ Medicaid is required
  • Excellent verbal and written communication skills
  • Long term/ short term case management experience is a plus

Send your most updated resume to christian.cruz@nezdaglobal.com.

 

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