ISTA Solutions is currently looking for experienced
PHRN Utilization Reviewer who have previous experience dealing with US Healthcare Insurance accounts, particularly in Utilization Management. This position entails semi-back-office work dealing with US-based Clients related to Claims, Benefits, Eligibility, Appeals, Prior Authorization, and particularly in MDS.
Process information based on standard operating procedures,
- Adhere to the client's process for data delivery and correspondence.
Coordinate with respective personnel through calls, emails, etc.
At least 2 years experience as a Utilization Reviewer / Clinical Nurse Reviewer for a US Healthcare account- Good working knowledge with
MDS (Minimum Data Set)
Must have an active PHRN license (USRN license is a PLUS)
- Must have Dialysis Training Certification
Good working knowledge with Clinical Appeals and Revenue Cycle Management- Excellent verbal and written English skills
Willing to work onsite in
Buendia, Makati- Amenable working night shifts
What can we offer you
- Competitive salary and benefits
Health Insurance with free dependents
Attendance Bonus
Convertible to cash leave credits Work-life balance
- A focus on growing your career path with us
We encourage you to follow your passions and learn new skills
Our commitment to you- Strong culture and values-driven leadership
We create opportunities for you to learn and grow at any stage of your career
- Continuous learning and innovation
We foster an all inclusive environment where everyone thrives
Job Types: Full-time, Permanent
Pay: Php40,- 00 - Php60,000.00 per month
Benefits: - Company events
Health insurance
Opportunities for promotion- Promotion to permanent employee
Schedule: Late shift
Night shiftSupplemental Pay: Overtime pay
Yearly bonus
Ability to commute/relocate:- Makati City: Reliably commute or planning to relocate before starting work (Required)
Application Question(s):- What would be your expected salary range
Experience:
Utilization Management Review: 1 year (Required)
