Job Description
Position:
MEDICAL CASE MANAGERS
Schedule: Monday – Friday,
8:00 AM – 5:00 PM MST (11:00 PM - 8:00 AM PH TIME)
Rate:
Php40,000.00/monthly
Medical Record Interpretation & Strategy:
- Review initial medical reports to assess injury severity (e.g., soft tissue vs. surgical)
- Read daily medical notes to understand why a doctor is recommending specific treatments (MRIs, injections, etc.)
- Determine causality: Verify that the treatment billed is actually related to the accident and not a pre-existing condition.
Financial Gatekeeping (Funding):
- Act as an internal Insurance Adjuster: Approve or deny treatment requests based on the patient's Policy Limits
Traffic Controller / Network Management:
- Coordinate referrals: Send patients to providers specifically within the client's approved network
- Radius Management: Locate providers near the patient's home to ensure they actually at...
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