Clinical Underwriting Consultant
RMS Collect Phils., Inc. Quezon City
Job Description
Location: Open to all sites in the Philippines
Profile Summary:
Profile Description:
- Serves as a subject matter expert in the evaluation of medical information to clarify
diagnoses, evaluate the severity of medical conditions, and estimate the duration of
treatment and expected future costs.- Researches clinical conditions and provides analytical review of the medical and/or
- Provide support to rate development through timely and accurate clinical and medical
analysis to ascertain future risks and support the underwriting and risk management
Decision.- Works collaboratively with the cost containment team ensure a proper hand off of potential high cost patients. Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate Cost Containment specialty teams to address these identified risks.
Knowledge & Experience:
- Bachelor's degree - current unrestricted RN license, or equivalent clinical degree
- Minimum 5 years of clinical experience
- Minimum 2 years insurance experience
- Analytical and problem solving skills
- Excellent interpersonal and negotiation skills to act as a company representative
- Experience in Microsoft Office products
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