Non-voice Appeals Strategist (phrn) Vacancies at GlobalTek BPO Inc

Job Info

GlobalTek PH is looking for PHRNs in a BPO setting with experience in a healthcare account to be part of our Non-Voice Appeals Strategist Team. 

Work Arrangement: Work from Home/Equipment will be provided. Fixed weekends off. 

Who We Are: 

We are an in-house BPO company who specializes in the medical claims field with the goal to help the underserved and at-risk disabled population in their quest to receive all the disability benefits they medically, legally, and ethically qualify for from both government and private entities. 

We develop medical evidence that helps our clients navigate the complex disability benefits journey to improve their life trajectory.

Job Description: 

The remote Appeals Strategist will be working directly with Veterans who will assist in reviewing medical symptoms and service-connected disabilities reported by the Veteran, develop a strategy plan, and identify supporting medical evidence.

They must identify which claims a Veteran medically qualifies for and assess the value or expected rating of each claim during the conversation. The Appeals Strategist will work closely with designated team members to answer questions about the case and provide clear direction for evidence development. Peer reviewing cases may be needed in addition to normal caseload.  

Essential Duties and Responsibilities: 

✔Reviewing medical records to formulate a strategy as needed. 

✔Reviewing lay evidence to determine if documentation supports the strategy. 

✔Reviewing Intake Screener tool to determine strategy.

✔Identifying VA disability claims which meet the VA requirements. 

Assessing potential value of claim strategy. 

✔Entering Claim Strategy in Zoho CRM. 

Responding to emails from Veterans and staff 

✔Exercising discretion and independent judgement with respect to matters of significance. 

✔Complying with and upholding HIPPA guidelines. 

✔Performing other duties as assigned 

✔Serves as a resource for strategy related questions. 

Qualifications: 

✅Must have an Associate Degree in Nursing or combination of education and experience – Candidate must have an existing PHRN License.

✅Must have a minimum 6 months to 1 year phone-based customer service experience in a BPO setting is required. 

✅Advanced knowledge on medical terminologies. 

✅Excellent written and verbal communication skills – Proficient in conversational English. 

✅Thorough knowledge of grammar, document creation, and APA format techniques.  

✅Excellent interpersonal skills, analytical and critical thinking skills. 

✅Proficient with Microsoft office applications, including Word, Excel and PowerPoint. 

✅Able to navigate complex tasks with objectives and resolutions. 

✅Ability to be detail-oriented, diligent, and flexible.

✅Ability to focus on task completion with little direction or need for supervisory follow up. 

✅Actively embraces and makes use of collaborative problem solving, diverse viewpoints, and unique skillsets.

✅Must be amenable to work in the night shift following the US Eastern Time Zone. 

✅A stable internet connection with at least 25 MBPS download/10 MBPS upload is required for this role. 

GlobalTek PH is an equal opportunity employer that is committed to diversity and inclusion in the workplace.

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Company Description

Company Info

• Industry: Call Center/IT-Enabled Services/BPO
• Company Size: 501 - 1000 Employees
• Average Processing Time: 8 days
• Benefits & Others: Regular hours, Mondays - Fridays, Business (e.g. Shirts), HMO Coverage; Competitive Salary Package, Weekends Off