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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.