PHRN (McKinley Taguig) | Onsite

Active Registered Nurse At least 1 year of BPO Clinical / Healthcare experience or 1 year of Bedside / Hospital Experience Strong communication skills Willing to work onsite in McKinley, Taguig

Responsibilities:

Clinical Review & Documentation: Analyzing medical records for accuracy, compliance, and appropriateness of care. Claims Processing: Determining patient eligibility, validating medical claims, and managing insurance coverage. Utilization Management: Reviewing treatment plans against medical policies to ensure cost-effective care. Case Management & Liaison: Communicating with healthcare providers and patients to facilitate care and resolve inquiries. Clinical Training (if applicable): Developing or delivering training programs for healthcare staff.