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Posted 4 months ago

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Case Management Specialist (US Healthcare Insurance) | Hybrid

Makati, Metro Manila, PhilippinesHybridFull-time

AI Summary

Case Management Specialist for US Healthcare Insurance, handling patient assessments, care planning, medical record review, and coordination with US insurance providers.

About this role

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Case Management Specialist to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Responsibilities:

  • Conduct initial assessments of patients' medical conditions, care needs, and treatment goals. Develop Healthcare plans tailored to each patient's requirements.
  • Administer medications, treatments, and medical procedures as prescribed by healthcare providers. Monitor vital signs and assist with wound care, IV therapy, or other medical interventions.
  • Maintain accurate and up-to-date patient records, documenting care provided, changes in condition, and any incidents or concerns.
  • coordinates with US insurance providers

Requirements

  • Graduate of Medical Allied Courses

  • Basic knowledge about Medicare and Medicaid

  • 1 year BPO Healthcare Experience related to reviewing medical records, authorization,claims, denials and appeals

  • Familiar with common medical terminologies

  • Good English verbal and written skills

  • Good work management skills

  • Familiar with common medical terms

  • Familiar with MS Office Tools and applications

Benefits

What can we offer you?

  • Competitive salary and benefits
  • Health Insurance with free dependents*
  • 10%-night differential
  • Attendance Bonus
  • Paid time off
  • Convertible to cash leave credits
  • Performance Appraisal
  • Work-life balance
  • A focus on growing your career path with us
  • We encourage you to follow your passions and learn new skills

Our commitment to you

  • Strong culture and values-driven leadership
  • We create opportunities for you to learn and grow at any stage of your career
  • Continuous learning and innovation
  • We foster an all inclusive environment where everyone thrives

Skills

AuthorizationBPO HealthcareClaims ProcessingDenials And AppealsIV TherapyMedicaidMedical Records ReviewMedical TerminologyMedicareMicrosoft OfficePatient RecordsVital Signs MonitoringWork ManagementWound Care

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