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.