Philippine Registered Nurse | PHP60,000* Hiring Bonus (1519)

**Get hired and receive PHP60,000 Signing Bonus! Submit your application now and receive a call within 1 to 2 working days!**Duties and Responsibilities:Manages incoming or outgoing telephone calls, emails, and/or faxes, including triage, opening of cases and data entry into client system.Determines contract; verifies eligibility and benefits.Adhere to federal and state regulatory and/or client plan requirements and established workflows.Obtains information from claimant or other supporting systems, emails and/or from fax. Manages claims, collection of non-clinical information needed for review from claimants and providers, utilizing scripts to screen basic and complex requests.Data entry of contact into client systems and route as appropriate.Tasks cases accurately to the correct queue.Performs leave follow-ups as required, including recertification of health conditions, intermittent claim tracking, Return to Work /confirm/iation, etc.Update systems to accurately reflect leave status and ensure appropriate documentation exists.Conducts outbound scripted calls to claimants and providers to request for clinical information.Review and assessment of primarily complex illness and injury claims.Identify restrictions and limitations based on physiological, psychological, and social factors to assist claim management staff in their claim handling activities.Validate the medical necessity of limitations and/or restrictions with clear rationale.Provide claim management staff with medical insight and education to assist them in determining appropriate determination.Discuss medical issues and documents outcomes of discussions.Uses available resources to understand contractual and regulatory compliance requirements and reports suspected compliance issues on the day of discovery to a Team Lead, Manager, and/or the Compliance Department.Responsible for reporting known or suspected data disclosures or fraud on the day of discovery to a Team Lead.Qualifications:Graduate of Bachelor’s Degree in NursingHolds active and unrestricted local (PH) Registered Nurse licenseMust have at least 3 months experience as a Registered Nurse in a clinical settingExperience in a front-office (voice) call center or BPO back-office environment is an advantageKnowledge of ICD-9 and ICD-10 and CPT codes is an advantageMust be amenable to work in Cubao, Eastwood, Mandaluyong, and other possible Accenture sites in Metro ManilaHow to apply?Apply in JobstreetClick on “Apply Now” to submit your application and upload your updated resume.In adherence to Accenture's process of Identity Verification, your resume or CV must include your photo to ensure the accuracy of your application and your during interviews, a snapshot of your image will be captured for the same purpose.For faster processing of your application, please make sure to have your latest NBI clearance ready. For successful candidates who worked with previous employers, please prepare your approved resignation letter, SSS employment history and Statement of Account. Your recruiters will also remind you of other requirements you can prepare ahead of time.Why join Accenture?Competitive salary package, company bonuses, and performance incentivesNight differentialLoyalty, Christmas gift, Inclusion and diversity benefitsPaid sick and vacation leavesExpanded maternity leave up to 120 days*HMO coverage (medical and dental) from day 1 of employmentLife insuranceEmployee stock purchase planRetirement planFlexible working arrangementsAccessible locationsHealthy and encouraging work environmentCareer growth and promotion opportunities*Terms and conditions apply