Healthcare Professional

1 day ago

Iloilo City, Western Visayas, Philippines beBeeClinical Full time $44,880 - $44,920
Job Overview

This position involves conducting comprehensive reviews and case consultations to support client care. The ideal candidate will be a licensed clinical or medical professional with expertise in behavioral health documentation and insurance requirements.

Key Responsibilities:
  • Conduct thorough peer reviews and case consultations to secure continued stay authorizations.
  • Review patient charts prior to peer reviews, including progress notes, psychiatric evaluations, history and physical exams, nursing assessments, and lab reports.
  • Collaborate with the clinical team to gather updated information that supports medical necessity for continued care.
  • Maintain knowledge of insurance medical necessity criteria, such as ASAM, MCG, and InterQual.
  • Accurately document all authorization interactions in the electronic medical record (EMR) system.
  • Participate in interdisciplinary team meetings to provide feedback on documentation practices.
  • Track authorization timelines to ensure seamless service delivery.
Required Qualifications:
  • Licensed Registered Nurse (RN)
  • Nurse Practitioner (NP), Medical Doctor (MD/DO), Licensed Therapist (LCSW, LPC, LMFT, PsyD, PhD)
  • Minimum 2 years experience in behavioral health, substance use, or psychiatric care
  • Prior experience with utilization review, case management, or insurance authorization processes
  • Familiarity with insurance platforms and payer-specific guidelines
  • Strong communication skills to present complex information clearly
  • Attention to detail and ability to work independently under pressure
Benefits:
  • Full-time remote job
  • Salary range: $10-$11 per hour
  • Senior-level position
Additional Details:
  • This is a full-time employment opportunity
  • 100% remote work arrangement

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