Intake Coordinator / Associate II

UST USource; Pateros; On-site; PHP 279,000 - 424,000; Full time

Job summary

UST USource is seeking a detail-oriented professional to support utilization management workflows in a fast-paced healthcare environment in Metro Manila, Philippines.

You will handle intake processing, data entry, and case assignments for UM referrals, load and assign cases daily across multiple lines, and manage large work queues including Medicare, maternity, and pediatrics. Strong multitasking and communication skills are essential.

Qualifications

• 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.

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.

Skills

Multitasking

Analytical skills

Attention to detail

Verbal communication

Written communication

Interpersonal skills

Teamwork

Workload management

Healthcare BPO experience

Education

Bachelor's degree (preferred)

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

• 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.