Key Responsibilities
- Review patient records and provider notes to validate clinical necessity
- Escalate cases appropriately to medical director
- Complete prior authorization forms and submit to payers via online portals or fax
- Coordinate with support staff to gather documentation and verify benefits
- Follow up on status of submitted requests and escalate delays appropriately
- Maintain documentation accuracy and compliance with turnaround time requirements
Requirements
- Active USRN license, based in the Philippines
- Minimum 4 years of experience in utilization management, prior authorization
- Familiarity with U.S. healthcare and payer systems
- Detail-oriented with strong communication and documentation skills
NIGHT SHIFT
WORK ONSITE - BGC
Job Types: Full-time, Permanent
Pay: Php25,000.00 - Php60,000.00 per month
Benefits:
- Health insurance
Schedule:
- Night shift
Supplemental Pay:
- 13th month salary
- Overtime pay
Application Question(s):
- What is your email add?
License/Certification:
- US RN certification (Required)