Crawford & Co.

GBSC-Clinical Program Nurse III

Job Locations PH-Manila
Posted Date 5 months ago(16/9/2022 9:07 AM)
Requisition ID
# of Openings
Medical Case Management


Responsible for providing proactive case management services by assessing existing medical records.

Job Scope

A. Case Management Services

  • Analyzes and reviews case records, evaluates client’s medical status, and defines their needs and problems
  • Provides opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendation to facilitate rehabilitation goals and return to work
  • Utilizes experience and medical resources to interpret medical records and test results, and provide appropriate assessments accordingly
  • Reviews cases with immediate superior monthly to evaluate files and obtain directions
  • Performs job site evaluations/summaries to facilitate case management process


B. Client Relations

  • Establishes professional working relationship with internal and external clients by timely return to work
  • Maintains contact with all parties involved on case to appraise them of case activity, case direction, or receive authorization for services

C. Business Process Support

  • Performs peer reviews and independent medical examination
  • Meets monthly production and quality assessment (QA) requirements
  • Deals with problem resolution independently by using appropriate research and resources
  • Refers matters beyond limits of authority and expertise to immediate superior for direction
  • Upholds the Crawford Code of Conduct by protecting the confidentiality of information
  • Performs other related tasks as required or needed

Functional Knowledge

  • Minimum of two (2) years diverse clinical experience or prior experience in Medical Bill Review.
  • Bachelor’s degree in Nursing.
  • Must be a Philippine Registered Nurse; has an active US Registered Nurse license from New York if required by the process.
  • Excellent verbal communication skills and customer orientation
  • Proficient in word processing software applications
  • Analytical skills - Ability to perform basic and complex bill review according to standard operating procedures (SOP)
  • Ability to deliver excellent customer service
  • Active listening and phone handling skills
  • Critical thinking skills - Ability to make judgements and recommendations
  • Maintains high degree of professionalism and confidentiality
  • Ability to multi-task, prioritize and manage time effectively
  • Interpersonal skills - Able to work independently and as a team member
  • Keen attention to details


Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Need help finding the right job?

We can recommend jobs specifically for you! Click here to get started.