USRN – Clinical Disability Claims Specialist
(Base Location for WFH)
(Base Location for WFH)
Job Description
Key Skills
1 candidate(s) have already applied for this Job. Apply now
*EXL | PHRN / USRN – Clinical Disability Claims Specialist*
*Location:Work From Home
*Work Setup:* Full-time, Shifting Schedule
*Salary & Benefits*
- Basic Pay: PHP 60,700 – PHP 85,700/month
- Complexity Pay: +PHP 3,000/month
- Standard Allowance: PHP 2,675/month
- Work From Home setup | HMO + Government benefits
- Career growth in Healthcare/Insurance RCM
*Job Description*
Perform Clinical Case Review for Disability Claims on a Short Term/Long Term Disability account. Review medical files, assess clinical documentation, and ensure accurate evaluation per insurance guidelines.
*Key Responsibilities*
- Conduct clinical file review for Short Term/Long Term Disability claims
- Evaluate medical records and clinical documentation for accuracy and completeness
- Apply private/commercial insurance guidelines to case assessments
- Ensure compliance with client-specific clinical criteria
- Maintain quality and turnaround time standards
*Required Qualifications*
- *License:* Must have an active PHRN or USRN license
- *Experience:* Clinical Disability Claims experience required, preferably in Short Term/Long Term Disability with clinical file review
- Insurance Background: Experience in private or commercial insurance required
- Clinical Role: Must be actively doing or have done Clinical Case Review
- *Bedside Experience:* With or without hospital bedside experience is acceptable
- *Eligibility:* Should not be a former or current employee of the client
NB
Clinical disability claims experience is mandatory, clearly Indicate it on your resume
Role
Philippines Registered Nurse
Timings
Rotational Shifts (Permanent)
Industry
BPO
Work Mode
Work from Home
Process
Voice
Functional Area
ITES / BPO / Customer Service
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