Work Setup: Onsite (McKinley Taguig)
Start Date: ASAP
Requirements:
- Active Pharmacist license in the Philippines
- At least 1 year of BPO Clinical / Healthcare experience or 1 year of pharmacy experience
- Strong English communication skills
- Willing to work onsite in McKinley, Taguig
- Amenable to be on a shifting schedule – predominantly on night shift with no guaranteed weekends off
Responsibilities:
- Clinical Review & Documentation: Analyzing medical records for accuracy, compliance, and appropriateness of care.
- Claims Processing: Determining patient eligibility, validating medical claims, and managing insurance coverage.
- Utilization Management: Reviewing treatment plans against medical policies to ensure cost-effective care.
- Case Management & Liaison: Communicating with healthcare providers and patients to facilitate care and resolve inquiries.
- Clinical Training (if applicable): Developing or delivering training programs for healthcare staff.