Peer Review Specialist

5 days ago

Cebu City, Central Visayas, Philippines RemoteRaven Full time ₱45,000 - ₱55,000 per year
Hiring: Peer Review Specialist – Behavioral Health | $10–$11/hr | Remote

Are you a licensed RN, NP, MD/DO, or Licensed Therapist with experience in behavioral health and insurance reviews? Join us as a Peer Review Specialist, where you'll ensure clients continue receiving the care they need by securing payer authorizations, reviewing documentation, and collaborating with clinical teams.

Rate: $10–$11/hr

Setup: 100% Remote

Schedule: Full-Time


Position Summary

The Peer Review Specialist will conduct clinical reviews, case consultations, and insurance payer communications to obtain continued stay authorizations across Residential, PHP, and IOP levels of care. You'll play a key role in bridging clinical expertise with payer requirements, ensuring compliance, accurate documentation, and uninterrupted client care.


Key Responsibilities
  • Conduct peer reviews and case consultations with insurance payers to secure continued authorizations.
  • Review client charts, including progress notes, psych evaluations, nursing assessments, and lab reports.
  • Collaborate with clinical/medical staff to gather updated information supporting medical necessity.
  • Apply payer criteria (ASAM, MCG, InterQual) during reviews.
  • Accurately document all interactions in EMR or designated systems.
  • Track authorizations, expirations, and review timelines to avoid service interruptions.
  • Participate in interdisciplinary team meetings and advise on documentation practices.
  • Uphold HIPAA, payer requirements, and ethical standards.

Required Qualifications
  • Minimum: Licensed RN
  • Preferred: NP, MD/DO, LCSW, LPC, LMFT, PsyD, or PhD
  • 2+ years of experience in behavioral health, substance use, or psychiatric care
  • Prior experience in utilization review, case management, or insurance authorization preferred
  • Familiarity with payer platforms and guidelines
  • Excellent communication and documentation skills
  • Strong attention to detail, ability to work under pressure, and independently

What We Offer
  • Competitive pay: $10–$11/hr
  • 100% remote work setup
  • Full-time, stable role with career growth potential
  • Opportunity to make a direct impact on client care access

How to Apply

Send your resume to with subject line:

Peer Review Specialist Applicant | JobStreet | [Your Name]

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