Clinical Appeals RN — Fast-Paced Healthcare Support

Concentrix; Quezon City; Sur place; PHP 335 000 - 536 000; Plein temps

Résumé du poste

Concentrix in the Philippines is seeking a licensed PHRN to support healthcare-related customer inquiries in a fast-paced BPO environment. You will apply clinical knowledge to assist members, providers, or patients and document information accurately.

The role emphasizes strong communication, confidentiality, and collaboration with internal teams to resolve issues, with familiarity in US healthcare processes and terminology.

Qualifications

• Active Philippine Registered Nurse (PHRN) license is required.
• At least 1 year of BPO experience, healthcare account preferred.
• Strong communication and customer service skills.
• Experience in Utilization Management, Prior Authorization, Clinical Appeals, Case Management, or Healthcare Customer Service.
• Familiarity with US healthcare processes and terminology.

Responsabilités

• Handle healthcare-related inquiries from members, providers, or patients
• Review and document medical information accurately
• Provide support regarding healthcare benefits, claims, authorizations, or clinical services
• Ensure compliance with company, client, and regulatory guidelines
• Maintain confidentiality of patient information and records
• Collaborate with internal teams to resolve customer concerns in a timely manner

Connaissances

Communication skills

Customer service

Clinical knowledge

US healthcare knowledge

Formation

Philippine Registered Nurse (PHRN) license

Description du poste

Concentrix in the Philippines is seeking a licensed PHRN to support healthcare-related customer inquiries in a fast-paced BPO environment. You will apply clinical knowledge to assist members, providers, or patients and document information accurately.

The role emphasizes strong communication, confidentiality, and collaboration with internal teams to resolve issues, with familiarity in US healthcare processes and terminology.