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Utility Review Nurse ADS

Utilization Review Nurse | US Registered Nurse

What we offer?

  • ₱50,000 – ₱65,000 Competitive Salary
  • Retirement/Life Insurance Plan.
  • ₱100k Signing Bonus
  • Medical Plan (HMO on Day 1)
  • Retirement Benefits
  • Non-voice
  • Work From Home
  • PC Provided
  • Hiring Anywhere
  • Free License Renewal
  • Free IELTS Training

Responsibilities:

  • Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.
  • Consults with medical and treatment staff regarding client diagnosis, medical justification, length of treatment, and case documentation.
  • Communicate with physicians to ascertain their plans for a timely discharge.
  • Handle inbound and outbound calls from patients and healthcare providers Analyze and determine the eligibility of medical claims.
  • Coordinate with providers and specialists in assessing the validity of claims.

Qualifications:

  • Must be an NCLEX Passer
  • Active US License is required for USRN positions (Illinois license is a major plus) 
  • Active PRC License 
  • With at least 1 year of Hospital Experience
  • Must be willing to work Graveyard shifts.
  • Permanent work-from-home agents must be willing to go onsite for client visits / short training.
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