Nursing Utilization Review Specialist

2 weeks ago


Makati City, National Capital Region, Philippines V-Assist Full time
Job Summary

We are seeking a skilled Nursing Utilization Review Specialist to join our team at V-Assist. In this role, you will conduct thorough reviews of patient care to ensure appropriateness and quality. Your strong communication skills and ability to multitask will be essential in collaborating with medical staff and resolving customer inquiries.

Responsibilities:

  • Conduct utilization reviews to ensure patients receive appropriate care for their condition.
  • Collaborate with medical staff on client diagnosis, treatment length, and documentation.
  • Verify document completeness and request any necessary information for claims.
  • Solve moderate to complex issues independently.
  • Professionally interact with customers and healthcare providers to resolve inquiries.
  • Gather feedback from patients regarding customer satisfaction.

Qualifications:

  • Bachelor of Science in Nursing graduate.
  • Active PHRN License.
  • Able to work on night shift.
  • Strong knowledge of medical terminology.
  • Good verbal and written communication skills.
  • Ability to multitask, organize, and prioritize tasks.


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