• Process incoming requests for authorization by entering key information including CPT and ICD-10 codes into the UR system.
• Verify compensability of requested treatment by reviewing claims notes.
• Ensuring that all demographic information regarding injured workers, requesting provider, attorneys and claims staff is correct in the UR system.
• Handling protected health information consistent with department and company policies and regulatory requirements.
• Attend training/educational classes as appropriate.
• Perform other duties and responsibilities as deemed necessary and assigned.
  
  

• An active Nursing license in the Philippines
• Experience in US Healthcare
• Must possess good written and oral communications skills
• Organized with excellent decision-making and time-management skills
• Typing speed of >45 words per minute is preferred.
• Ability to multitask in a fast-paced environment
• Proficient in MS Outlook, Word and Excel with general computer literacy
• Willing to work any assigned shift during a work week in Makati City
• Preferably with Workers Compensation background and knowledgeable in ICD-10 codes and utilization review process, but not required
  
  

Please refer to job description.