USRN – Clinical Disability Claims Specialist

Gratitude Inc

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1 month ago

USRN – Clinical Disability Claims Specialist

1-14 Year(s)

₱ 60 - ₱ 85K p.m

NA
(Base Location for WFH)

Job Description

Key Skills

Inbound BPO BPO Voice Process BPO Skills PHRN BPO industry BPO Recruitment BPO Hiring BPO Call center International BPO BPO/ITES INSURANCE CLAIM Insurance industry Bedside experience USRN & PHRN PHRN or USRN active PHRN License active PHRN and USRN license

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*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

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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Norman Bogonko

Recruiter - Gratitude Inc

NA, kenya

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