Managed Care, Insurance & BPO (US Healthcare)

Verified

$6/hr

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Outline

Looking for Freelance work (20 hours/day) at $6/hour

Bachelor's Degree

English proficiency Conversational

Professional Summary

Versatile Registered Nurse with expertise in utilization review, clinical content moderation, and customer service operations. Skilled at applying clinical guidelines to evaluate medical documentation, manage appeals/grievances, and ensure compliance across digital platforms and insurance workflows. Adept at navigating complex healthcare policies, conducting thorough quality audits, and resolving multi-party inquiries with empathy and accuracy. Seeking to leverage hybrid clinical and operational expertise in a Utilization Review, Quality Assurance, or Digital Health role.

Skills & Experience

Skills

Utilization Management/ Back Office 2-5 Years

Chat support, Email Support, Phone Support, Content Moderator 5-10 Years

Customer Service Representative 5-10 Years

Experience highlights

Utilization Review

AGS Health · December/2023 – Present

Utilization Review Nurse

Access Healthcare · April/2022 – Present

Customer care Representative

Sykes Asia · October/2008 – Present

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