Utilization & Denials Management Lead — Onsite Night Shift

MicroSourcing; Taguig; Presencial; PHP 900 000 - 1 200 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Healthcare coverage Day 1

Dependent coverage

Paid time off with cash conversion

Group life insurance

Performance bonuses

Resumo da oferta

MicroSourcing is seeking an experienced Utilization & Denials Management Supervisor in Taguig. You will lead a team focused on utilization review and denials, ensuring compliance with payer guidelines and high performance. This onsite, night-shift role demands strong leadership and collaboration with Billing and IT teams.

You will drive process improvements, monitor SLAs, and mentor staff while advancing revenue-cycle operations and under the MicroSourcing banner.

Qualificações

• BS in Nursing with active PHRN or USRN license.
• 1+ year supervisory experience in Utilization Management or Denials & Appeals.
• 3–5 years acute care clinical experience in hospital setting.
• Proficiency with InterQual or MCG guidelines and US regulations.
• Experience with EMR systems (Epic, Cerner, Meditech).
• Excellent English communication (CEFR B2).
• Strong leadership and multitasking in a fast-paced healthcare environment.

Responsabilidades

• Lead and supervise a team of Utilization Review and Denials & Appeals specialists.
• Monitor productivity, quality, turnaround time and SLAs; address gaps.
• Oversee timely review and resolution of UM, denials, and appeals per guidelines.
• Audit compliance with payer regulations and documentation requirements.
• Analyze denial trends; collaborate with Billing, Coding, HIM, and Revenue teams.
• Develop and present KPI dashboards and leadership updates.
• Collaborate with IT to optimize EMR and denials systems.
• Mentor staff on utilization management and regulatory updates.

Conhecimentos

Supervisory experience

InterQual/MCG knowledge

EMR proficiency

English communication

Formação académica

BS in Nursing

Master's degree (preferred)

Ferramentas

Epic

Cerner

Meditech

Microsoft Office

Descrição da oferta de emprego

MicroSourcing is seeking an experienced Utilization & Denials Management Supervisor in Taguig. You will lead a team focused on utilization review and denials, ensuring compliance with payer guidelines and high performance. This onsite, night-shift role demands strong leadership and collaboration with Billing and IT teams.

You will drive process improvements, monitor SLAs, and mentor staff while advancing revenue-cycle operations and under the MicroSourcing banner.