Utilization Reviewer

Muntinlupa, National Capital Region

Posted more than 30 days ago


Company:: Human Utilization Management Solution
Company Description:: We are a healthcare solutions company dedicated to providing review services across hospitals. We are looking for PH registered nurses who are willing to work in a hybrid set up. Get the opportunity to receive above-average compensation. Our office is located in Madrigal Business Park, Alabang, Muntinlupa City. Send us your resume and be part of our growing team.
Contract Type:: Contract
Experience Required:: 1 year
Education Level:: Bachelor’s Degree
Gender:: Any
Number of vacancies:: 2

Job Description

This role is an open-end contract position with a hybrid work setup. Please apply only if you are amenable to these terms.

The Utilization Reviewer evaluates the appropriateness and necessity of medical services provided to patients. Meticulously reviewing medical records ensures that care aligns with medical guidelines, insurance coverage, and patient needs. Collaborating closely with healthcare providers, you'll drive efficient resource utilization while maintaining high-quality patient care and cost-effectiveness.

Qualifications:
Must be a PH registered nurse.
At least 1 year experience in a clinical setting.
At least 1 year experience in a BPO setting.
Knowledge of HIPAA and US medical insurance is an advantage.

BPO: 1 year (Preferred)
Hospital: 1 year (Preferred)