usource jobs in Manila

UST USource is seeking a Claims Processor to adjudicate medical claims for a U.S. payer using TriZetto Facets. The role covers end-to-end processing, eligibility checks, benefit validation, and pricing application in a BPM environment.Key requirements include a graduate degree and 5+ years of U.S. healthcare payer claims experience, with strong analytical,...

UST USource is seeking a Claims Lead for BPM (Facets Claims Operations) to oversee end-to-end claims delivery within a Facets environment. The role emphasizes governance, workforce management, quality oversight, and SLA adherence across multiple queues to drive efficiency and accuracy. The ideal candidate will have a graduate degree and 8+ years in U.S....

UST USource is seeking a Utilization Management (UM) Quality Assurance Nurse to support quality improvement through audits, performance analysis, and ensuring compliance with UM policies and procedures. The role collaborates with leadership to evaluate performance, develop educational materials, support system implementations, and contribute to continuous...

UST USource in Taguig City, Metro Manila is seeking a Sr. Corporate/Volume Recruiter to support rapid hiring across Healthcare, IT and other niche roles. This full-time role partners with hiring managers to fill multiple roles efficiently and maintain compliant recruitment processes.You will source, screen, interview, and coordinate offers, manage ATS...

UST USource is seeking an Intake – Chart Retrieval QRM Associate to review, validate, and process medical records for quality review and case management. The role requires meticulous attention to detail, strong analytics, and ability to work across multiple applications while ensuring HIPAA compliance.Responsibilities include collaborating with RNs and...

UST USource is seeking a Provider Data Management Analyst to review, validate, and maintain accurate provider information within our BPM environment in Manila. You will support outreach verification, returned mail handling, credentialing record updates, and PIMS claim-related setup, while meeting quality, productivity, and SLA targets.The successful...

UST USource is seeking a Team Lead for Provider Data Management (PDM) to oversee end-to-end data maintenance services within a BPM environment. You will lead outreach verification, returned mail resolution, credentialing updates, and PIMS claim support while ensuring data accuracy, governance, and SLA adherence.The role requires strong leadership, process...

UST USource in Metro Manila, Philippines, seeks a customer service representative to respond to inquiries about insurance benefits, claims, and contracts. You will analyze issues, document information in the database, and maintain outcomes for tracking.The role requires 1 year in automated customer service and a high school diploma, with a night shift onsite...

UST USource is seeking an IRE Analyst to review appeal cases for regulatory compliance and quality standards. You will perform quality audits, identify improvement opportunities, and provide feedback to support accurate, timely case handling. You will collaborate with the Appeals & Grievances Quality team and Supervisor to promote quality outcomes and member...

UST USource in Manila is seeking a Jira administration specialist to manage and optimize our Jira Software, Jira Service Management, and Confluence platforms.You will design workflows, manage projects, users, and permissions, build dashboards, and develop automation and REST API integrations to improve visibility and efficiency.The role also covers system...

About the role UST is seeking a Sr. Corporate/Volume Recruiter to join our Recruitment team in Taguig City, Metro Manila. This is a full-time position that plays a crucial role in supporting our organisation's growth and talent acquisition objectives for various Healthcare, IT and other niche roles. Key responsibilities Source, screen, and interview...

Job Description: Utilization Management (UM) Quality Assurance NurseJob SummaryThe Utilization Management (UM) Quality Assurance Nurse is responsible for supporting quality improvement initiatives by conducting comprehensive audits, analyzing operational processes, identifying trends and opportunities for improvement, and ensuring compliance with utilization...

The Provider Data Management (PDM) Analyst is responsible for reviewing, validating, updating, and maintaining accurate provider information within a Business Process Management (BPM) environment according to approved Premera processes and procedures. The role supports outreach verification, returned mail, credentialing record updates, and PIMS claim-related...

Role Summary The Claims Processor is responsible for performing accurate, compliant, and end-to-end medical claims adjudication within the TriZetto Facets platform for a U.S. healthcare payer. Operating within a Business Process Management (BPM) environment, the role supports claims processing activities including pended, exception, corrected, and...

The Provider Data Management (PDM) Team Lead is responsible for end-to-end operational leadership of provider data maintenance services within a Business Process Management (BPM) environment. The role oversees provider outreach verification, returned mail, credentialing record updates, and PIMS claim support while ensuring accurate provider records,...

The Intake – Chart Retrieval QRM Associate is responsible for reviewing, validating, and processing medical records to support quality review and case management activities. This role requires a high level of attention to detail, strong analytical skills, and the ability to work efficiently across multiple applications while ensuring compliance with HIPAA,...

Claims Lead – BPM (Facets Claims Operations) Role Summary The Claims Lead will oversee end-to-end claims operations within a Business Process Management (BPM) environment supporting a U.S. healthcare payer. This role is responsible for operational delivery, governance, workforce management, quality oversight, escalation management, process optimization,...

Key Responsibilities:Respond to customer inquiries via telephone and written correspondence, providing accurate and comprehensive information about insurance benefits, claims, and provider contractsAnalyze customer issues and deliver effective solutions promptly and professionallyRetrieve and document customer information, activities, and changes accurately...

JOB SUMMARY The IRE Analyst is responsible for reviewing appeal cases to ensure compliance with regulatory requirements and quality standards. This role performs quality audits, identifies process improvement opportunities, and provides feedback to support accurate, timely, and compliant case handling. The analyst works closely with Appeals & Grievances...

Administer and maintain Jira Software, Jira Service Management (JSM), and Confluence platformsConfigure and manage projects, workflows, screens, issue types, schemes, and custom fields to meet business requirementsManage users, groups, roles, permissions, and Confluence spaces, ensuring appropriate access controlsDesign and create dashboards, reports,...