Intake Coordinator / Associate II

UST; Taguig; On-site; PHP 246,000 - 357,000; Full time

Job summary

UST in Metro Manila seeks a Healthcare UM Intake Data Entry Specialist to support case processing and data entry for utilization management. You will interact with nurses, insurance adjusters, facilities, and other healthcare professionals to gather and route referrals and assign cases efficiently.

The role emphasizes accurate data entry, EMR handling, and managing multiple queues across Medicare, maternity, and pediatrics, ensuring cases meet established turnaround times and NCQA standards.

Qualifications

• Bachelor's degree preferred.
• Minimum of 6 months Healthcare BPO experience.
• Proficient multitasking across multiple systems.
• 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.

Responsibilities

• Interact with nurses, insurance adjusters, facilities, and healthcare professionals.
• Process intake and data entry of UM referrals and case assignments.
• Load and assign cases to nurses on daily, weekly, and monthly cadences.
• Manage large work queues across Medicare, maternity, and pediatrics.
• Review and prioritize cases based on urgency and turnaround time (TAT).
• Evaluate faxes by identifying member and case information and linking documents to open requests.
• Scan, upload, index, and label case documents.
• Support clinicians by routing inbound faxes to the appropriate queue.
• Collect, organize, and maintain medical records for utilization review processing.
• Prepare EMRs for review and ensure documentation is queued.
• Determine workflow and routing for services requested through documentation.
• Support NCQA compliance by identifying urgent vs non-urgent cases.
• Contact facilities for updates regarding member status.

Skills

Healthcare Systems

Data Entry

Business Operations

Data Validation

Education

Bachelor's degree preferred

Tools

Aerial EMR

Job description

Role Description

• 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.

Successful hires will be required to provide requirements including COE / proof of employment in previous work, NBI clearance, education documents (school registration form are accepted).

Skills

• Healthcare Systems
• Data Entry
• Business Operations
• Data Validation