Deskripsi Pekerjaan
Are you a USRN or NCLEX passer ready to elevate your career? Optum, a leader in global health innovation, is looking for experienced nurses to join our dynamic team in Metro Manila. We are dedicated to evolving health care, and we want you to be a part of our mission to help everyone live their healthiest life.
In this role, you will leverage your clinical expertise in a high-impact, professional environment. We offer a competitive compensation package, comprehensive benefits from Day 1, and the opportunity to work with cutting-edge healthcare technology. If you are passionate about patient outcomes and ready to transition into a rewarding career within a global organization, we want to hear from you.
Tanggung Jawab
- Evaluate and process healthcare claims based on clinical guidelines and insurance policies.
- Collaborate with cross-functional teams to ensure high-quality patient care standards.
- Maintain accurate medical documentation and ensure compliance with HIPAA and other healthcare regulations.
- Conduct clinical reviews for medical necessity and service authorizations.
- Provide expert clinical insights to streamline patient service delivery.
- Act as a subject matter expert for non-clinical team members regarding medical terminology and procedures.
- Participate in regular audits to ensure precision and quality in clinical decision-making.
Kualifikasi
- Active US Registered Nurse (USRN) license (or NCLEX passer).
- Minimum of 1-2 years of solid clinical hospital experience.
- Strong command of the English language, both written and verbal.
- Proficiency in basic computer applications and navigating clinical software.
- Exceptional analytical and problem-solving skills.
- Ability to adapt to changing workflows in a fast-paced BPO/Healthcare environment.
- Must be willing to work on-site in Metro Manila.