Registered Nurse

Posted 9 February by Pavilion Recruitment Solutions
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We are currently recruiting on behalf of a Global Private Medical Insurance company based in the heart of Brighton who are looking for a Global Case Manager (qualified Nurse or Doctor) to join their team.

Within this role you will resume responsibility for investigating and responding to enquiries for complex medical pre-authorisation and high value claims. You will triage cases, work and liaise with members, providers, service partners and intermediaries via telephone, email, fax and letter to advise of requests and and fully explain benefit entitlements.

You will also ensure all parties - broker, company, provider, service partner and colleagues who are involved are kept up to date on the progress of authorisation of claims and case details. You will have an integral role in the current case management process as well as audit and on-site case review. Prepare cost reports for each investigation that is performed, negotiate medical costs and or medical treatment, support global medical teams and log all communication throughout your role.

Experience -

- Bachelor degree or above in healthcare or related discipline
- Doctor or Registered Nurse with speciality.
- Experience in utilisation review or case management
- Knowledge of Medical Coding systems

Hours - Full time hours
Salary - Competitive Salary + excellent company benefits

Required skills

  • Health Insurance
  • Registered Nurse
  • Insurance Claims
  • Case Manager
  • Registered Doctor

Reference: 41384116

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