Utilization Review Nurse | US Registered Nurse
What we offer?
● ₱50,000 – ₱65,000 Competitive Salary
● Retirement/Life Insurance Plan.
● ₱100k to 200k 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.