About the job
Work Setup: WFH
Start Date: January 11, 2027
Qualifications:
- Active PRC
- Valid passport (at least 6 months)
- At least 2 years of bedside experience.
- Own equipment during review (laptop, desktop, or tablet)
Responsibilities:
- Responsible for the review and evaluation of clinical information and documentation, fax triage and conversion, and provider calls.
- Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality
- Data gathering requires navigation through multiple system applications.