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USRN Appeals And Grievances Nurse | Permanent Work in the house | income 75K:Job description:Hiring Customer Service and BPO Jobs for Various Accounts DAY & NIGHT SHIFT / TELECOM, FINANCIAL, Information technology / HELPDESK, TECHNICAL SUPPORT, HEALTHCARE, SALES, EMAIL / CHAT SUPPORT, HOTEL/TRAVEL RESERVATION, BILINGUAL & BACK OFFICE POSITIONS Job Description . USRN Appeals and Grievances Nurses (Permanent Work in the house) Review and evaluate appeal and grievance requests to identify and classify member and provider appeals Determine eligibility, benefits, and prior activity related to the claims, payment or service in question Perform comprehensive research related to the facts and circumstances of a member complaint, to include appropriate classification as a grievance, appeal, or both, in conformity with regulatory requirements Responsible for making verbal contact with the member or authorized representative during the research process to further clarify, as needed, the member's complaint. Accountable for appropriate review and determination in compliance with state and federal regulations Job Requirements . USRN - Appeals and Grievances Nurses Permanent Work in the house Set-up income P75,000 to P85,000 plus Signing Bonus P150,000 Minimum QualificationsHolder of Active USRN License from any Mainland State With 1-2 years Appeals and Grievances practice gained from working in the BPO industry or any US healthcare company Willing to work on night shift - rotational weekends off Must be residents of Greater Metro Manila area (provincial candidates outside of Metro Manila, Laguna, Cavite, Rizal and Bulacan will not be considered) Job Function . Customer Service / BPO / Call CenterHealthcare / Medical Minimum Education . College or Bachelor's Degree Graduate income . 55,000 and Above Benefits . Shift Allowance, Nightshift Differential, Performance Incentives, SSS/Philhealth/HDMF Benefits, HMO Locations . Metro Manila Employment Duration . Permanent (Full time) Total Years practice . 1 year practice in Call Center BPO . 1 year Skills:
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