Healthcare Utilization Review Specialist

Company Overview:Cognizant Technology Solutions Philippines Inc. is a leading provider of healthcare solutions, dedicated to delivering exceptional patient care and outcomes.Job Summary:We are seeking an experienced Nursing Professional to join our team as a Healthcare Utilization Reviewer. As a key member of our healthcare operations team, you will play a...

Sherewater Health is looking for a talented Utilization Review Manager to lead our utilization review team. As a key member of our clinical leadership team, you will play a critical role in driving results and improving patient outcomes.Develop and implement utilization review strategies to improve team performance and patient satisfaction.Provide clinical...

Job OverviewOmega Healthcare Management Services Inc. is seeking a skilled and detail-oriented individual to join our team as a Clinical Authorization Coordinator.About the RoleThis role plays a critical part in ensuring seamless communication between healthcare providers, payers, and patients by prioritizing incoming authorization requests and processing...

Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities:Perform advanced level work related to clinical denial and utilization...

Are you a detail-oriented individual looking for a challenging role in a BPO healthcare setting? As a Medical Allied Professional at Access Healthcare Services Manila, Inc., you will play a key role in ensuring the timely and accurate processing of prior authorization requests for medical procedures and treatments.Job Description:This role involves reviewing...

Access Healthcare is looking for motivated and detail-oriented individuals to join our Healthcare Prior Authorization team.Key Responsibilities:Review and process prior authorization requests from healthcare providers.Verify patient insurance coverage and ensure compliance with payer requirements.Coordinate with healthcare providers, insurance companies, and...

DCX PH Inc. seeks a talented Utility Billing Specialist to join our team! As a key member of our Client Services department, you will play a crucial role in delivering exceptional results for our clients. Your primary responsibilities will include providing accurate and timely utility billing calculations, preparing annual settlements by property and utility...

We are seeking a highly skilled Medical Adjudication Specialist to join our team at Hive Health Pte Ltd. This role plays a key part in optimizing our healthcare operations by reviewing, analyzing, and validating medical availments and claims.About the Ideal CandidateThe successful candidate will have at least 3 years of relevant clinical experience and be...

Access Healthcare is looking for a highly skilled Team Leader to oversee operations for our Pharmacy Utilization account based in Taguig City. The ideal candidate must be a Licensed Pharmacist with extensive experience managing U.S. healthcare accounts, particularly in pharmacy utilization management, prior authorization, and compliance. This role requires...

Unlock Your Potential in a Dynamic RoleAbout Us:At Access Healthcare Services Manila, Inc., we are dedicated to delivering exceptional customer service to the healthcare industry. Our mission is to provide timely and accurate solutions to our clients' needs.Your New Role:We are seeking a highly skilled Healthcare Account Resolution Specialist to join our...

Access Healthcare is looking for a Utilization and Clinical Denials Nurse to join our growing clinical account. The ideal candidate is a Licensed Philippines Nurse with at least one (1) year of hospital bedside experience and a strong understanding of utilization review, clinical documentation, and denial management in a BPO set-up. This role involves...

Job Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgency.Review patient's clinical and chart documentation related to the service submitted by the provider's office.Obtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...

Sourcing Specialist at Access Healthcare ServicesAccess Healthcare is looking for a Registered Nurse to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, and processing surgery authorizations as needed.Qualifications:Registered Nurse with Active license.BPO...

At Hive Health Pte Ltd, we're on a mission to make healthcare radically more accessible for all. Our team is passionate about delivering innovative solutions that truly matter.About the RoleThis role plays a key part in optimizing our healthcare operations by meticulously reviewing and analyzing medical availments and claims. You will ensure accuracy,...

Job OverviewInLife Health Care seeks a highly skilled Healthcare Network Development Specialist to join our team. This role is responsible for expanding and retaining our network of healthcare providers in the National Capital Region.Key Responsibilities:Network Expansion: Identify and scout prospective healthcare providers, represent InLife Health Care in...

Company Overview:Omega Healthcare Management Services Inc. is a leading provider of healthcare solutions.Salary:The salary range for this position is competitive and commensurate with experience.Job Description:This is an excellent opportunity to join our team as a US Registered Nurse with specialized care experience.Required Skills and Qualifications:Must...

Hive Health Pte Ltd is a leading provider of healthcare services in the Philippines. We are seeking a talented Medical Adjudication Specialist to join our team.About the RoleThis role involves optimizing our healthcare operations by reviewing, analyzing, and validating medical availments and claims. The ideal candidate will have excellent verbal and written...

**About the Role:**As a healthcare data analyst at Care Solutions and Outsourcing Corp., you will be responsible for reviewing and analyzing medical charts to ensure accurate coding and reimbursement.This is an excellent opportunity to utilize your analytical skills and knowledge of medical coding systems to contribute to the success of our...

As a Credit Balance Specialist, you will be responsible for reviewing and managing credit balances on patient accounts, ensuring proper resolution in accordance with insurance policies and company procedures. You will work closely with patients, insurance companies, and internal teams to resolve discrepancies, process refunds, and ensure accurate financial...

About the JobWe are seeking a Healthcare Operations Specialist to join our team. In this role, you will be responsible for reviewing evaluations, plans of treatment, progress notes, and other clinical documentation within turnaround time.Key ResponsibilitiesClinical Documentation Review: Review evaluations, plans of treatment, progress notes, and other...