Job Title: PHRN/USRN – Clinical Disability Claims

Project: AMERON
Location: Nationwide, Philippines
Work Setup: Work From Home
Shift: Shifting Schedule
Employment Type: Permanent
Salary: Confidential (Based on experience)
Headcount: 3
Target Start Date: TBD

Job Summary

We are looking for experienced PHRN or USRN professionals with a background in Clinical Disability Claims and hospital bedside care. The ideal candidate should have experience handling clinical case reviews for Short-Term Disability (STD) and Long-Term Disability (LTD) claims in a private or commercial insurance environment.

Key Responsibilities

• Conduct clinical case reviews for disability claims.

• Evaluate Short-Term and Long-Term Disability claims based on clinical documentation.

• Review medical records and determine claim eligibility according to clinical guidelines.

• Ensure accurate and timely claim decisions while maintaining quality standards.

• Collaborate with internal teams to resolve claim-related concerns.

• Maintain compliance with company policies and healthcare regulations.

Qualifications

• Active PHRN or USRN license.

• Minimum 3 years of hospital bedside experience, preferably in intensive care.

• Minimum 2 years of Clinical Disability Claims experience.

• Experience handling Short-Term Disability (STD) and/or Long-Term Disability (LTD) claims.

• Experience in private or commercial insurance is required.

• Experience conducting Clinical Case Reviews.

• Strong analytical, documentation, and communication skills.

• Must not be a current or former employee of the client.

Preferred Background

Candidates from companies such as:

• Genpact

• Optum

• VXI

• Accenture

Recruitment Process

• Initial Screening

• Profile Validation

• Virtual Interview (10:00 AM – 5:00 PM)

• Operations Interviews

• Final Selection

Pre-Screening Questions

• Do you have an active PHRN or USRN license?

• How many years of hospital bedside experience do you have?

• How many years of Clinical Disability Claims experience do you have?

• Do you have experience with Short-Term or Long-Term Disability claims?

• Have you worked in private or commercial insurance?

• Are you willing to work from home on a shifting schedule?

• What is your current salary?

• What is your expected salary?

• What is your notice period?