Clinical Analyst Level I

2 days ago

Mandaluyong City, National Capital Region, Philippines Medrisk Llc Full time ₱250,000 - ₱500,000 per year

Position Summary

The primary role of the Clinical Analyst position is to assist in the clinical processes associated with clinical oversight of worker's compensation cases. Focus is on Certified Hand Therapy, Occupational Therapy, Pool Therapy, Physical Therapy, Word Conditioning, Work Hardening, and TeleServices programs. The Analyst has the potential to participate in the collection of non-clinical and clinical data, collection of necessary documentation for clinical review, and complete clinical reviews, which requires evaluation and interpretation of clinical information. When assisting in Teleservices, the Analyst will be involved with activities, which allows the injured worker to move through the program from scheduling for the initial visit through discharge from services. All areas the Clinical Analyst participates in may require calls to US-based MD/therapy offices with discussion with the front office staff and/or the treating therapist. Calls to Patients may occur in areas of the TeleServices program.

Primary Duties & Responsibilities

  • Clinical Oversight:
    • Confirming attendance of initial evaluation (IE) and receipt of IE Report 
    • Reviews documentation and updates cases with accurate clinical information, including but not limited to ICD codes, Date of Surgery, Clinical Guidelines, ROM/Strength measurements 
    • Initiates review for requested service upon referral o Review types include Continued Authorization and Internal Clinical Reviews 
    • Obtains, compiles, proofs and processes information received from providers/adjusters to aid in the final determination of a clinical reviewer. 
    • Reviews all assigned cases to provide efficient, cost-effective and quality utilization review services. 
  • Teleservices:
    • Opens new Telerehab cases in the system and participates in scheduling injured workers for Telerehab 
    • Manages phone calls coming into department through the Telerehab Queue (internal and external calls) 
    • Monitors and handles Telerehab inbox including email, voicemail and fax communications for Teleservices team 
    • Participates in processing continued authorization for Telerehab cases including communication with physician offices and adjusters 
    • Handles other Teleservices duties as assigned
  • Overall Duties:
    • Documents all pertinent clinical patient/case information and actions into the case notes. 
    • Complies with all established policies and procedures 
    • Assists manager and team in quality improvement projects to provide instructive feedback to practitioners within scope 
    • Attends meetings and trainings. 
    • Meets quality management standards. 
    • Performs activities within the scope of professional licensure. 
    • Completes other duties and projects as assigned.

Qualifications 

  • Must hold a current Philippines Physical Therapy License 
  • Experience: 2-3 years of outpatient hospital clinic setting strongly preferred 
  • Knowledgeable of current physical medicine treatments 
  • Excellent verbal and written communication skills 
  • Organizational skills, prioritization, problem-solving and decision making skills are required 
  • Ability to multi-task in a fast paced environment 
  • Must be computer literate and be able to use the keyboard accurately. Experience with Microsoft Office and Zoom app are desired. 
  • Strong analytical and interpersonal skills are also required. 
  • Not required, but desired: current US Physical Therapy license and/or Doctor of Physical Therapy degree 
  • Experience in utilization review, case management, quality improvement and/or managed care is desired

  • Data Analyst Level I

    1 week ago

    Mandaluyong City, National Capital Region, Philippines MedRisk LLC Full time ₱900,000 - ₱1,200,000 per year

    Job SummaryIn the role of a Data Analyst Level I, the primary responsibility is to support the development of data-driven solutions that influence decision-making across the organization. This involves generating ad hoc reports using SQL and Excel, and supporting the development of automated MIDAS reports for end-users. The role also includes assisting in...

  • AccountsReceiveAnalyst Level I

    5 days ago

    Mandaluyong City, National Capital Region, Philippines MedRisk LLC Full time ₱900,000 - ₱1,200,000 per year

    Accounts Receivable Analyst Level IThe primary role of the Accounts Receivable Analyst is to facilitate accurate and timely receipt of revenue. Through the course of standard revenue processes, the analyst is expected to identify trends and areas of opportunity that will result in more efficient workflows and optimal collection rates. This individual will...

  • AccountsReceiveAnalyst Level I

    5 days ago

    Mandaluyong City, National Capital Region, Philippines MedRisk LLC Full time ₱144,000 - ₱180,000 per year

    Accounts Receivable Analyst Level IThe primary role of the Accounts Receivable Analyst is to facilitate accurate and timely receipt of revenue. Through the course of standard revenue processes, the analyst is expected to identify trends and areas of opportunity that will result in more efficient workflows and optimal collection rates. This individual will...

  • Clinical Bill Review Nurse

    7 days ago

    Mandaluyong City, National Capital Region, Philippines Genfinity Full time ₱900,000 - ₱1,200,000 per year

    TheClinical Bill Review Nurseis responsible for reviewing medical bills and associated documentation to ensure accuracy, medical necessity, and compliance with workers' compensation guidelines. This role supports payment integrity by identifying inappropriate charges, ensuring adherence to jurisdictional fee schedules, and applying clinical expertise to...

  • Clinic Administrative Associate

    2 days ago

    Mandaluyong City, National Capital Region, Philippines The Medical City Full time ₱300,000 - ₱450,000 per year

    I. Purpose of the PositionThis role serves as the initial contact point for patients thus ensuring proper service architecture is given by assisting them with general inquiries, validating information for medical care access, verifying accuracy of billing purposes, and providing quality patient experience such as medical and diagnostic services.II. Key...

  • Clinical Bill Review Nurse

    7 days ago

    Mandaluyong City, National Capital Region, Philippines Genfinity Full time ₱900,000 - ₱1,200,000 per year

    The Clinical Bill Review Nurse is responsible for reviewing medical bills and associated documentation to ensure accuracy, medical necessity, and compliance with workers' compensation guidelines. This role supports payment integrity by identifying inappropriate charges, ensuring adherence to jurisdictional fee schedules, and applying clinical expertise to...

  • Customer Advocate Level I

    1 week ago

    Mandaluyong City, National Capital Region, Philippines MedRisk LLC Full time ₱180,000 - ₱360,000 per year

    Position SummaryAs a Customer Advocate, you will be supporting communication between MedRisk/SPNet's network providers and referring adjusters and nurse case managers. You will report to the Customer Advocate Team Lead and/or Supervisor to help strengthen MedRisk/SPNet's referral process, ensuring efficient workflow, while increasing customer satisfaction....

  • Sr Data Analyst

    1 week ago

    Mandaluyong City, National Capital Region, Philippines MedRisk LLC Full time ₱1,200,000 - ₱2,400,000 per year

      Job SummaryIn the role of a Senior Data Analyst, the individual is expected to drive the development of data-driven solutions that influence decision-making across the organization. This involves generating ad hoc reports using SQL and Excel, as well as developing automated MIDAS reports for end-users with a focus on creating standardized and optimized...

  • Clinical Applications Services Quality Assurance

    2 weeks ago

    Quezon City, National Capital Region, Philippines Systemantech, Inc Full time ₱780,000 per year

    Job Description:Primary Responsibility:The Clinical Applications Services Quality Assurance (CASQA) Analyst is responsible for ensuring that all system enhancements, process changes, and related documentation meet the highest standards of quality, functionality, and compliance before deployment. This role focuses on validating that the developed solution...

  • IT Security Analyst I

    5 days ago

    Quezon City, National Capital Region, Philippines Advanced Energy Industries, Inc. Full time ₱1,500,000 - ₱3,000,000 per year

    IT Security Analyst IAbout Advanced EnergyAdvanced Energy Industries, Inc. (NASDAQ: AEIS), enables design breakthroughs and drives growth for leading semiconductor and industrial customers. Our precision power and control technologies, along with our applications know-how, inspire close partnerships and innovation in thin-film and industrial manufacturing....