Care Management Analyst | PHRN
Accenture Philippines
- Mandaluyong, PhilippinesRobinsons Cybergate Towers 1, 2 and 3, EDSA cor. Pioneer Street, Mandaluyong City, Manila, 1554 Metro Manila, Mandaluyong, Metro Manila, PhilippinesMandaluyongMetro ManilaPhilippinesPhilippines
- Toàn thời gianFULL_TIME
Công việc đã đóng.
Miêu Tả Về Công Việc
To provide support to the clinical team and client team to assist in the promotion of quality member outcomes, to optimize member benefits, and to promote effective use of resources. Supports the procedures that ensure adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective.
- Determine customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented.
- Assess medical appropriateness of claims submitted, and adjust claims as needed.
- Pay all covered claims accurately and timely.
- Manage both new claims and open claims equally and maintains decision turnaround times.
- Understand the client’s operations and corporate compliance, policies and procedures and best practices.
35K Signing Bonus!
Terms and Condition Apply
Trình độ tối thiểu
- BS Nursing (BSN) Degree
- Active PH RN License holder
- A minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting required
- Three months is equivalent to 480 hours of working experience as an RN
- Working experience as a Registered Nurse means holding an active RN license and providing direct patient care
- Clinical setting includes inpatient hospital, outpatient hospital or clinic
- year of customer service or call-center experience and a minimum of work experience is a plus
Tóm tắt công việc
- Trình Độ Công Việc
- Phó Giám Sát/Giám Sát
- Ngành Nghề
- Health and Medical
- Yêu cầu học vấn
- Tốt nghiệp Cử nhân
- Nhà tuyển dụng trả lời hồ sơ
- Always
- Địa chỉ văn phòng
- Robinsons Cybergate Towers 1, 2 and 3, EDSA cor. Pioneer Street, Mandaluyong City, Manila, 1554 Metro Manila
- Ngành nghề
- Information Technology / IT
- Vị trí đang tuyển
- 1 vị trí tuyển dụng mới
- Trang web
- https://www.accenture.com/ph-en
Về Accenture Philippines
Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations. We help organizations maximize their performance and achieve their vision. We develop and implement technology solutions to improve our clients’ productivity and efficiency — and may run parts of their operations on their behalf. Ultimately, we enable our clients to become high-performance businesses and governments. With approximately 442,000 people serving clients in more than 120 countries, Accenture drives innovation to improve the way the world works and lives.