Utilization Reviewer Nurse

2 weeks ago

Dumaguete, Philippines Lunas Solution Full time

Job Opening Utilization Reviewer Nurse Job Industry Hospital & Health Care Job Type Full-Time Experience Level Entry Level Date Posted Job Location Yap Hall, BallfieldDumaguete City6200Negros OrientalPhilippinesWork-from-Home/Telecommute Offered Company Information Lunas SolutionYap Hall, BallfieldSillimanDumaguete City, Negros Oriental6200Lunas Solution is a BPO company that specializes in managing healthcare accounts and delivering essential healthcare services. With expertise in utilization review and clinical documentation improvement, Lunas helps healthcare providers enhance operational efficiency, optimize patient care, and ensure accurate and compliant documentation. The company is operating in Muntinlupa since 2022 and has expanded to Dumaguete. Job Description This role is an open-end contract position with a hybrid work setup. Please apply only if you are amenable to these terms. The Utilization Reviewer evaluates the appropriateness and necessity of medical services provided to patients. Meticulously reviewing medical records ensures that care aligns with medical guidelines, insurance coverage, and patient needs. Collaborating closely with healthcare providers, you’ll drive efficient resource utilization while maintaining high-quality patient care and cost-effectiveness. Job Qualifications Must be a PH registered nurse. At least 1 year experience in a clinical setting. At least 1 year experience in a BPO setting. Knowledge of HIPAA and US medical insurance is an advantage. Fresh graduates with PHRN license may apply. Compensation ₱30,000 - ₱50,000 Number of Job Opening 30 Highest Education Attainment College Graduate #J-18808-Ljbffr

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