Care Management Ph RN Voice Analyst - Viventis Search Asia | New Day Jobs (Yangon, Myanmar)

Industry: Outsourcing/Offshoring

Job function: Health Care Provider

Seniority: Associate

Job Details:

Multinational professional services company

Graveyard Shift

Full-time Employment

Voice-based operations

Temporary WFH Setup for 2021

Competitive Salary Package

HMO Coverage

Remote/Virtual Recruitment Process

Responsibilities:

Claims management for Absence and Disability Insurance: Gathers info and performs variety of complex clerical or administrative support functions w/c require knowledge and understanding of disability policies and process to appropriately calculate the benefits due.

Manages incoming or outgoing telephone calls, emails, and/or faxes, including triage, opening of cases and data entry into client system.

Determines contract; verifies eligibility and benefits. Adhere to federal and state regulatory and/or client plan requirements and established workflows.

Obtains information from claimant or other supporting systems, emails and/or from fax. Manages claims, collection of non-clinical information needed for review from claimants and providers, utilizing scripts to screen basic and complex requests.

Qualifications:

Holds current and unrestricted local (PH) Registered Nurse license.

Bachelor of Science Nursing (BSN) degree

minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting required

Three months is equivalent to 480 hours of working experience as an RN;

Work experience as a Registered Nurse means holding an active RN license and providing direct patient care;

Knowledge of disability claims management process and ability to interpret and apply member contracts, and member benefits; Knowledge of ICD-9 and ICD-10 and CPT codes, preferred;

The interview process will be remotely. This position is open to all PH Registered Nurse only.