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Staff Nurse
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- Posted 28 days ago
- Be among the first 10 applicants
Job Description
Qualifications
- Graduate of a medical-allied course (e.g., Nursing, Medical Technology, Pharmacy, Physical Therapy, Radiologic Technology, etc.).
- Must have completed a clinical internship with hands-on experience in a hospital, clinic, or healthcare facility during college.
- Strong communication and interpersonal skills.
- Willing to work onsite and on shifting schedules.
- Fresh graduates with relevant clinical internship experience are encouraged to apply.
- Respond to customer inquiries regarding healthcare plans, benefits, coverage, and other related services through phone, email, or chat.
- Provide accurate, timely, and professional assistance to members, healthcare providers, and clients.
- Verify member eligibility, benefits, and policy information.
- Coordinate with hospitals, clinics, physicians, and other healthcare providers regarding member concerns and requests.
- Assist in processing authorizations, referrals, and claims-related inquiries in accordance with company policies.
- Document customer interactions accurately and maintain complete records in the system.
- Resolve customer concerns and complaints while ensuring a high level of customer satisfaction.
- Ensure compliance with company policies, healthcare regulations, and data privacy standards when handling confidential information.
- Escalate complex cases to the appropriate department for immediate resolution.
- Maintain productivity and quality standards while delivering excellent customer service.
- Stay updated on healthcare policies, HMO products, and company procedures through continuous training.
- Perform other duties and responsibilities that may be assigned by management.
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