Case Management Specialist | US Health Insurance

ISTA Solutions

Makati

On-site

PHP 279,000 - 446,000

Full time

7 days ago

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Benefits offered by this job

Health Insurance with free dependents*

10%-night differential

Attendance Bonus

Paid time off

Convertible to cash leave credits

Performance Appraisal

Work-life balance

Career growth opportunities

Job summary

ISTA Solutions is seeking an experienced Case Management Specialist to join our expanding team in the Philippines. You will conduct initial assessments of patients, develop tailored healthcare plans, and assist with treatments while maintaining precise records.

You will coordinate with US insurance providers to ensure smooth claims processing. The ideal candidate has a medical allied background, Medicare/Medicaid knowledge, and at least one year in a healthcare BPO, with strong English

Qualifications

Graduate in Medical Allied courses with relevant clinical grounding.
Knowledge of Medicare and Medicaid basics.
At least 1 year in BPO healthcare reviewing medical records, authorization, claims, denials and appeals.
Familiar with common medical terminologies and terminology usage.
Proficient in MS Office applications and tools.

Responsibilities

Conduct initial assessments of patients' medical conditions and care needs.
Develop healthcare plans tailored to each patient's requirements and goals.
Administer medications, treatments, and procedures as prescribed; monitor vitals and wound care as needed.
Maintain accurate patient records and coordinate with US insurance providers.