USRN/PHRN-EXL Pasay WFH

*EXL | PHRN / USRN – Clinical Disability Claims Specialist* *Location:Work From Home *Work Setup:* Full-time, Shifting Schedule *Salary & Benefits* - Basic Pay: PHP 60,700 – PHP 85,700/month - Complexity Pay: +PHP 3,000/month - Standard Allowance: PHP 2,675/month - Work From Home setup | HMO + Government benefits - Career growth in Healthcare/Insurance RCM *Job Description* Perform Clinical Case Review for Disability Claims on a Short Term/Long Term Disability account. Review medical files, assess clinical documentation, and ensure accurate evaluation per insurance guidelines.*Key Responsibilities* - Conduct clinical file review for Short Term/Long Term Disability claims - Evaluate medical records and clinical documentation for accuracy and completeness - Apply private/commercial insurance guidelines to case assessments - Ensure compliance with client-specific clinical criteria - Maintain quality and turnaround time standards *Required Qualifications* - *License:* Must have an active PHRN or USRN license - *Experience:* Clinical Disability Claims experience required, preferably in Short Term/Long Term Disability with clinical file review - Insurance Background: Experience in private or commercial insurance required - Clinical Role: Must be actively doing or have done Clinical Case Review - *Bedside Experience:* With or without hospital bedside experience is acceptable - *Eligibility:* Should not be a former or current employee of the client

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