Utilization Review Coordinator: Elevate Patient Care

Health Business Solutions LLC; Manila; On-site; PHP 334,800 - 558,000; Full time

Job summary

A healthcare solutions provider in Metro Manila is seeking a skilled Utilization Review Coordinator to oversee patient insurance certification and ensure compliance with regulations. Responsibilities include evaluating patient records, managing case reviews, and collaborating with payors. Ideal candidates have a Bachelor’s degree in a medical field and experience in Managed Care. The role requires effective communication skills and detail-oriented work. Join a dynamic team focused on improving patient care and satisfaction.

Qualifications

• Bachelor’s degree in a related medical field.
• Experience in Managed Care or Health Plan.
• Moderate computer proficiency with Microsoft Office.

Responsibilities

• Evaluate patient records for severity of illness.
• Apply medical necessity screening criteria.
• Manage case reviews in the electronic system.
• Collaborate with payor sources for reimbursement.
• Document all activities in the review record.

Skills

Detail-oriented

Effective oral and written communication skills

Team-oriented approach

Independent functioning

Education

Bachelor’s degree in nursing, physical therapy, medical technician, HIMS, or a related medical field

Tools

Microsoft Office Suite

Job description

A healthcare solutions provider in Metro Manila is seeking a skilled Utilization Review Coordinator to oversee patient insurance certification and ensure compliance with regulations. Responsibilities include evaluating patient records, managing case reviews, and collaborating with payors. Ideal candidates have a Bachelor’s degree in a medical field and experience in Managed Care. The role requires effective communication skills and detail-oriented work. Join a dynamic team focused on improving patient care and satisfaction.