Healthcare Intake Coordinator (Seasonal)

UST; Philippines; On-site; PHP 279,000 - 469,000; Part time

Job summary

UST is seeking a Healthcare BPO professional for a 6-month contract. The role involves handling UM referrals, data entry, and case routing across Medicare, maternity, and pediatrics.

The candidate should have at least 6 months of Healthcare BPO experience, strong multitasking, analytical skills, and attention to detail, with excellent verbal and written communication. Collaborative teamwork and ability to work in a fast-paced healthcare setting are essential.

Qualifications

• Minimum of 6 months of Healthcare BPO experience.
• College education required; a bachelor's degree is preferred.
• Excellent multitasking across multiple systems and applications.
• Strong analytical and problem-solving abilities.
• Excellent attention to detail and accuracy.
• Effective verbal and written communication skills.
• Strong interpersonal skills and ability to work collaboratively in a team.
• Ability to manage workload efficiently in a fast-paced healthcare setting.

Responsibilities

• Interact professionally with nurses, insurance adjusters, facilities, and other healthcare professionals.
• Perform intake processing and data entry of UM referrals and case assignments.
• Load and assign cases to nurses on a daily, weekly and monthly basis.
• Manage large work queues across multiple business lines (Medicare, maternity, pediatrics).
• Review and prioritize cases based on urgency and turnaround time requirements.
• Evaluate incoming faxes by identifying member and case information and linking documents to open requests.
• Scan, upload, index, and label case documents in the case management system.
• Support clinicians by managing inbound faxes and routing documents to the correct queue.
• Collect, organize, and maintain medical records for utilization review processing.
• Sort and prepare EMRs and related documents for review.
• Ensure case documentation is queued and accessible for clinicians to review.
• Determine workflow and routing for services requested through incoming documentation.
• Support compliance with NCQA standards by identifying urgent vs non-urgent cases and turnaround times.
• Contact healthcare facilities to obtain updates on member status and case information.

Skills

Healthcare BPO

Multitasking

Analytical skills

Attention to detail

Verbal and written communication

Team collaboration

Education

Bachelor's degree

Tools

Aerial system

Job description

Key Responsibilities

• Professionally interact with nurses, insurance adjusters, facilities, and other healthcare professionals.

• Perform intake processing and data entry of Utilization Management (UM) referrals and case assignments.

• Load and assign cases to nurses on a daily, weekly, and monthly basis.

• Manage large work queues across multiple business lines, including Medicare, maternity, and pediatrics.

• Review and prioritize cases based on urgency and established turnaround time (TAT) requirements.

• Evaluate incoming faxes by identifying member and case information and conducting research within the Aerial system to accurately link documents to open requests.

• Scan, upload, index, and appropriately label case documents within the case management system.

• Support clinicians by managing inbound faxes in the Managed Care folder and ensuring documents are routed to the appropriate queue.

• Collect, organize, and maintain medical records and supporting documentation for utilization review processing.

• Separate, sort, and prepare Electronic Medical Records (EMRs) and related documents for review.

• Ensure case documentation is accurately queued and readily available, enabling clinicians to efficiently complete the review process.

• Determine the appropriate workflow and routing path for services requested through incoming documentation, ensuring timely assignment to the correct clinical reviewer.

• Support compliance with NCQA standards by accurately identifying urgent versus non-urgent cases and adhering to applicable turnaround times.

• Contact healthcare facilities to obtain updates regarding member status and related case information.

Qualifications

• Amenable to working on a 6-month contract.

• College education required; a bachelor's degree is preferred.

• Minimum of 6 months of Healthcare BPO experience.

• Proficient in multitasking across multiple systems and applications.

• Strong analytical and problem-solving abilities.

• Excellent attention to detail and accuracy.

• Effective verbal and written communication skills.

• Strong interpersonal skills and ability to work collaboratively within a team environment.

• Ability to manage workload efficiently in a fast-paced healthcare setting.

Preferred Competencies

• Knowledge of Utilization Management (UM) processes and healthcare workflows.

• Experience handling medical records, referrals, claims, or case management documentation.

• Familiarity with case management systems such as Aerial or similar healthcare platforms.

• Understanding of healthcare compliance requirements, including turnaround time standards and quality metrics.