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(ACTIVE-URGENT) PHRN/ USRN Healthcare Clinical Disability Claims | WFH

Gratitude Inc
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1 month ago

(ACTIVE-URGENT) PHRN/ USRN Healthcare Clinical Disability Claims | WFH

5-10 Year(s)
Manila
(Base Location for WFH)
Manila
(Base Location for WFH)

Job Description

Key Skills

USRN PHRN Healthcare Insurance Medical Claims processing ICU/CCU nursing experience Hospital bedside experience Clinical disability claims

128 candidate(s) have already applied for this Job. Apply now

Job Title: PHRN/USRN – Clinical Disability Claims

Project: AMERON
Location: Nationwide, Philippines
Work Setup: Work From Home
Shift: Shifting Schedule
Employment Type: Permanent
Salary: Confidential (Based on experience)
Headcount: 3
Target Start Date: TBD

Job Summary

We are looking for experienced PHRN or USRN professionals with a background in Clinical Disability Claims and hospital bedside care. The ideal candidate should have experience handling clinical case reviews for Short-Term Disability (STD) and Long-Term Disability (LTD) claims in a private or commercial insurance environment.

Key Responsibilities

  • Conduct clinical case reviews for disability claims.

  • Evaluate Short-Term and Long-Term Disability claims based on clinical documentation.

  • Review medical records and determine claim eligibility according to clinical guidelines.

  • Ensure accurate and timely claim decisions while maintaining quality standards.

  • Collaborate with internal teams to resolve claim-related concerns.

  • Maintain compliance with company policies and healthcare regulations.

Qualifications

  • Active PHRN or USRN license.

  • Minimum 3 years of hospital bedside experience, preferably in intensive care.

  • Minimum 2 years of Clinical Disability Claims experience.

  • Experience handling Short-Term Disability (STD) and/or Long-Term Disability (LTD) claims.

  • Experience in private or commercial insurance is required.

  • Experience conducting Clinical Case Reviews.

  • Strong analytical, documentation, and communication skills.

  • Must not be a current or former employee of the client.

Preferred Background

Candidates from companies such as:

  • Genpact

  • Optum

  • VXI

  • Accenture

Recruitment Process

  • Initial Screening

  • Profile Validation

  • Virtual Interview (10:00 AM – 5:00 PM)

  • Operations Interviews

  • Final Selection

Pre-Screening Questions

  • Do you have an active PHRN or USRN license?

  • How many years of hospital bedside experience do you have?

  • How many years of Clinical Disability Claims experience do you have?

  • Do you have experience with Short-Term or Long-Term Disability claims?

  • Have you worked in private or commercial insurance?

  • Are you willing to work from home on a shifting schedule?

  • What is your current salary?

  • What is your expected salary?

  • What is your notice period?



Role

Nurse

Timings

Rotational Shifts (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Work from Home

Process

Non-Voice

Functional Area

Medical Professional / Healthcare Practitioner / Technician

Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.

Recruiter profile

Bibi Hukkeri

Recruiter - Gratitude Inc

NA, india

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