USRN - InterQual Account
MetHealth
職位描述
福利待遇
員工表彰與獎勵
績效獎金, 周年禮物, 月度獎, 員工表彰計畫, 節日禮物
法定福利
13薪, 員工貸款, Pag-Ibig 基金, 帶薪假, 菲爾健康, SSS/GSIS
健康保險
健康保險, 人壽保險, 健康維護組織
職業發展
員工援助計畫, 職業發展, 獎學金計畫
簡介
- Health Insurance Education & Support: Assist patients with understanding insurance coverage, claims results, and care navigation across complex medical conditions and multi-provider coordination.
- Leadership & Mentorship: Act as a clinical resource for less experienced team members, provide coaching and feedback, and support professional development within the team.
- Complex Problem Solving & Analysis: Solve moderately to highly complex problems by interpreting clinical data, identifying trends, and offering actionable solutions with minimal supervision.
- Research & Evidence-Based Review: Conduct non-clinical research to support benefit determinations and ensure that final decisions are grounded in the latest clinical evidence and standards.
- Documentation & Reporting Excellence: Maintain high standards of accuracy and timeliness in clinical review documentation, ensuring all decisions are well-supported and communicated to stakeholders.
- Temporary Work-From-Home Setup
職位要求
- Must have At least 2 Years Hospital Experience
- 2 years Healthcare BPO Experience (As Utilization Management or Clinical Denial and Appeals)
- Active USRN License
- Must have knowledgeable with Interqual Or MCG Guidelines System
- Must Be Amenable To Work On-Site For The First 2 Weeks To Get The Assets or Equipment
Del Poso Kirby
OwnerMetHealth
回應率高
工作地址
Cebu City. Cebu City, Cebu, Philippines
發布於 02 July 2025
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