Nurse Case Management Support – US WC Claims

genfinity; Makati; On-site; PHP 558,000 - 893,000; Full time

Job summary

Genfinity Philippines, Inc. is seeking a US-licensed nurse in the Philippines to support Nurse Case Management for workers’ compensation claims.

The role provides clinical-administrative support to ensure timely communications, documentation, and file updates under the direction of a Nurse Case Manager. Responsibilities include coordinating communications, reviewing case details, and maintaining provider records, while adhering to jurisdictional and client-specific requirements.

Qualifications

• Active nursing license in the Philippines and in the mainland US.
• At least one year experience supporting US healthcare.
• Experience in Workers’ Compensation, Utilization Review, Case Management, or related clinical operations preferred.
• Strong understanding of clinical documentation, medical terminology, provider communication, and injured worker support processes.
• Ability to follow jurisdictional, client-specific, and case-specific communication requirements with a high degree of accuracy.

Responsibilities

• Confirm whether injured worker contact is permitted by the assigned Nurse Case Manager and document the approved method of communication, including call, text, or email.
• Confirm employer contact details and document any special instructions included in service instructions
• Ensure communications and support activities comply with applicable jurisdictional requirements, client instructions, and internal case management protocols.
• Send the welcome packet and medical records release to the injured worker when permitted, and confirm receipt of both documents.
• Send injured worker text reminders for new assignments, notices of visit, and updates from medical visits as appropriate.
• Summarize new document uploads, injured worker descriptions of accident, conversations with the injured worker, and relevant medical visit updates in the case file.
• Review the job description and attach to the file when available in service instructions.
• Provide a summary of documentation related to injured worker work status and attach any work status forms available in the file.
• Record provider information, including name, specialty, and contact information for each treating provider.
• Prepare and send pre-appointment letters to medical providers with relevant case content as directed.
• Import savings data from ancillary services for inclusion in the final report.
• Perform other assigned duties and responsibilities as deemed necessary.

Skills

Excellent written and verbal

Attention to detail

Computer literacy

US business hours

Team coordination

Education

Active Nursing license (Philippines and US)

Tools

MS Office Suite

Electronic Medical Records

Case management platforms

Job description

Genfinity Philippines, Inc. is seeking a US-licensed nurse in the Philippines to support Nurse Case Management for workers’ compensation claims.

The role provides clinical-administrative support to ensure timely communications, documentation, and file updates under the direction of a Nurse Case Manager. Responsibilities include coordinating communications, reviewing case details, and maintaining provider records, while adhering to jurisdictional and client-specific requirements.