PHRN TEMP WFH lUMR l PRIOR AUTH VIRTUAL PROCESS START ASAP

3 days ago


Manila, National Capital Region, Philippines Nezda Technologies, Inc. Full time

Seeking a detail-oriented and organized professional to manage UMR and pre-auth processes, with a strong understanding of medical necessity guidelines and denials.

**Job Summary:**

We are looking for a skilled PHRN or USRN to join our team, with a strong background in clinical experience and knowledge of UMR and pre-auth processes.

**Responsibilities:**

  • Manage UMR and pre-auth processes with a strong understanding of medical necessity guidelines and denials
  • Utilize clinical experience to make informed decisions and resolve complex issues
  • Develop and maintain strong relationships with internal stakeholders and external partners

**Requirements:**

  • 2 years of experience without clinical experience
  • Minimum 1 year of UMR and/or pre-auth experience with knowledge of denials and medical necessity guidelines
  • 1 year of clinical experience (bedside Medical Surgical, ER or OR)
  • 1 year of BPO with clinical experience or 2 years of BPO without clinical experience

**Offer:**

  • PHRN UMR: up to $50k package (Temp WFH)
  • USRN UMR: up to $75k (onsite)


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