Clinical Disability Claims Specialist (PHRN/USRN) | Permanent WFH | Nationwide

Gratitude Inc

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1 month ago

Clinical Disability Claims Specialist (PHRN/USRN) | Permanent WFH | Nationwide

2-10 Year(s)

₱ 62 - ₱ 85K p.m

Manila
(Base Location for WFH)

Job Description

Key Skills

Documentation Medical Assistance Nursing case handling PHRN Healthcare Insurance Patient Centric Mindset Disability claims Medical Claims processing BS Nursing Health Insurance Claims Processor Bachelors in Nursing USRN & PHRN PHRN or USRN Claims & Billing ICU/CCU nursing experience bedside nursing experience Experience in healthcare specifically in Disability Claims reviewing medical data or documentation Bachelor's Degree in Nursing active PHRN License Excellent clinical interpretation skills based on limited information provided along with a comprehensive understanding of medical terminology Clinical disability claims PHRN/ USRN Active license

10 candidate(s) have already applied for this Job. Apply now

Work Setup: Permanent Work From Home

Schedule: Shifting Schedule
Location: Nationwide (Philippines)

Salary

A2 Level

Basic Salary: PHP 60,700–66,800
Complexity Allowance: PHP 3,000
Standard Allowance: PHP 2,675

B1 Level

Basic Salary: PHP 73,200–85,700
Complexity Allowance: PHP 3,000
Standard Allowance: PHP 2,675

We are looking for experienced PHRN or USRN Clinical Disability Claims Specialists with strong clinical assessment experience and a background in commercial or private insurance.

Key Responsibilities

Conduct comprehensive clinical case reviews for disability claims.
Evaluate medical documentation and determine eligibility for Short-Term and Long-Term Disability claims.
Apply clinical judgment while adhering to company policies and regulatory guidelines.
Collaborate with internal teams to ensure timely and accurate claim decisions.
Maintain detailed and accurate case documentation.

Qualifications

Active PHRN or USRN license (required).
Minimum of 3 years of hospital bedside experience, preferably in intensive care or critical care settings.
At least 2 years of Clinical Disability Claims experience.
Experience handling Short-Term Disability (STD) and/or Long-Term Disability (LTD) claims.
Experience in private or commercial insurance is required.
Must have hands-on experience performing clinical case reviews.
Willing to work on a shifting schedule.
Amenable to a permanent work-from-home setup.

You are encouraged to APPLY!

WE ARE HIRING.

Role

Admin Services/Medical Facilities

Timings

Rotational Shifts (Permanent)

Industry

BPO

Work Mode

Work from Home

Process

Voice

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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