Clinical Appeals RN | Utilization Review | WFH (Ortigas)

EPSILON GROUP SERVICES INC.; Manila; Hybrid; PHP 446,000 - 558,000; Full time

Job summary

EPSILON GROUP SERVICES INC. is hiring a Philippine Registered Nurse (PHRN) with clinical appeals and utilization review experience for a role located in Ortigas, Pasig.

The position is initially a temporary work-from-home arrangement with onsite reporting required after the temporary period ends. The ideal candidate has a valid PHRN license, at least 1 year of bedside acute care experience, plus 1 year in inpatient appeals/utilization review and familiarity with InterQual.

Qualifications

• Active and valid PHRN License
• At least 1 year bedside care experience in an acute care setting
• Minimum 1 year experience in Clinical Appeals for Inpatient Denials/Utilization Review
• Experience handling Inpatient and Continued Stay Reviews
• At least 1 year experience using InterQual
• Strong clinical knowledge and documentation skills
• Excellent written and verbal communication skills

Skills

Clinical appeals

Utilization review

InterQual

Communication skills

Documentation skills

Tools

InterQual

Job description

EPSILON GROUP SERVICES INC. is hiring a Philippine Registered Nurse (PHRN) with clinical appeals and utilization review experience for a role located in Ortigas, Pasig.

The position is initially a temporary work-from-home arrangement with onsite reporting required after the temporary period ends. The ideal candidate has a valid PHRN license, at least 1 year of bedside acute care experience, plus 1 year in inpatient appeals/utilization review and familiarity with InterQual.