USRN - Clinical Disability Claims Specialist
60000 - 85000 PhpFull-time
Gratitude Inc
*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
Vacancy posted 4 days ago
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