The posting
This position will provide clinical support in a non-hospital setting, assisting in various healthcare-related services such as medical review, claims processing, utilization management, or telehealth support for clients in the US or other international locations.
Responsibilities: - Review medical records and clinical documentation for accuracy, completeness, and compliance. - Assist in the processing of health insurance claims, ensuring alignment with clinical standards and payer guidelines. - Provide clinical input in utilization management, pre-authorization, or appeals processes. - Conduct outbound and/or receive inbound calls related to patient care, benefits verification, or prior authorization.
Requirements: - Active PRC License - At least 1 year of hospital/clinical experience - Previous BPO healthcare experience is a plus - Excellent communication skills, both verbal and written



