Philippine Registered Nurse
1 Year or less Experience
15F Mabuhay Tower, IT Park, Lahug, Cebu City, Cebu
Shearwater Health (formerly known as Health Connections) is an expert provider of a wide-range of clinical processes, combining clinical outsourcing expertise and judgment with disciplined business practices. Our approach to healthcare outsourcing enables our clients to improve healthcare outcomes and the quality of service and care, as well as increase their return on investment.
Shearwater Health (formerly known as Health Connections) CPO expertise grew out of HCCAI's expertise with recruiting clinical staff and consulting on healthcare operations in over twenty-seven different countries since its establishment in 1973. We have developed relationships with some of the world's top healthcare systems to understand clinical needs and to implement clinical workforce strategies to improve care efficiency and nurse workforce stability. And through that experience we have truly become experts at identifying, recruiting, and selecting nurses of the very highest quality for our clients. And we're ready to put them all to work for you.
Responsible for coordinating the execution and continued quality of the client’s Utilization Review Department Process, performs assigned duties including telephonic on-line authorization of routine services, contacting specialty care providers, monitoring patient eligibility, and performing on-line data entry of routine authorizations/denials.
May be tasked to do any of the following:
- Bill Review
- Claims Assistant / Claims Support Specialist
- Client Service Representative
- Clinical Abstractor
- Clinical Data Coordinator
- Clinical Support Specialist
- Demand Package Solutions Nurse Review
- Intake Specialist
- Medical Coder
- Medical Coordinator
- Nurse Review
- Panel Card
- Physician Review Prep Nurse
- Physician Review Service Coordinator
- Pre-Authorization Representative
- Quality and Training
- Candidate must possess at least Bachelor's/College Degree in Nursing.
- Candidate must have an ACTIVE PRC LICENSE
- Must have at least 6 months to 1 year hospital/bedside experience (volunteer work included)
- Experience with CPO or any BPO Healthcare Account is an advantage
- Excellent oral and written communication skills in English
- Amenable to work shifting hours
- Candidate must possess at least Bachelor's/College Degree, Professional License (Passed Board/Bar/Professional License Exam), Nursing or equivalent
- Required Skill(s): Medical Abstraction, Utilization Review, Bill Review, Charts Review
We are looking for committed individuals who are driven to provide the best quality of service and allow our clients to improve on healthcare outcomes. Shearwater Health is awarded as the "Best Emerging IT-BPM Company for Healthcare for 2016" by the 10th ICT Awards! We are confident that once you'll be part of our team, you will not regret it. We provide a warm and friendly atmosphere together with above the market compensation packages!