Utilization Review Specialist (Patient Advocate)

Full-time Work From Home
3 - 4 Years of Experienced Taguig

Utilization Review Specialist (Patient Advocate)

Full-time

JOB DESCRIPTION

As the Utilization Role Specialist, you are expected to oversee quality treatment to be offered by the medical people and group especially the doctors and nurses to their patients.

JOB QUALIFICATION

SCHEDULE: 8 AM – 5 PM Mountain Standard Time, follows Philippine Holidays

POSITION TYPE: Full Time

WORK ARRANGEMENT: Remote

ESSENTIAL FUNCTIONS

 >       Review and evaluate the insurance plans of clients and their patients

>       Provide recommendations to optimize plan utilization or to help secure treatment

>       Establish rapport with clients and their patients by providing support and showing compassion

>       Negotiate with insurance companies to secure treatments on the client's behalf

>       Monitor cases and follow through to completion

>       Submit reports on cases and perform other administrative tasks

QUALIFICATIONS

·       A Bachelor’s degree in the related field or commensurate experience

·       Behavioral Health Clinical experience is a plus

·       Experience or knowledge of the behavioral health industry a plus

·       Basic understanding of health insurance benefits, deductibles, and plan designs

·       Knowledge of the insurance treatment authorizations process

·       Proven history of results-driven performance

·       Proven track record of advancement due to performance

·       Ability to handle and work with confidential scenarios

·       Organized and detail-oriented, but flexible as things change

·       Have a steady hand (aka calm under pressure)

·       Resourceful with the ability to solve complex problems

·       Desire to fight for/advocate for others

·       Experience in a multi-client environment

·       Strong computer aptitude, which includes expertise with Microsoft 365 applications and Google

·       Strong organization, oral and written communication skills

·       Aptitude in data management, analytics, reporting preparation

·       Ability to function in an autonomous environment—independent worker, self-directed

OTHER JOB REQUIREMENTS

Education
Bachelor’s Degree / College Degree
Field of study
Business Studies/Administration/Management, Medical Science
Specialization
Nurse/Medical Support, Others

JOB BENEFITS

Health Card, Allowance

WORK LOCATION

Taguig

COMPANY PREVIEW

Average application processing time
Less than 1 week


Dress Code
Any

Language
Industry
BPO / Call Centers

Telephone No.
+63 28287888

Mobile No.
+63 9978908470

Company Size
200 employees

Benefits

Working Hours
Sunday
Closed
Monday
1:00 am-1:00 am
Tuesday
1:00 am-1:00 am
Wednesday
1:00 am-1:00 am
Thursday
1:00 am-1:00 am
Friday
1:00 am-1:00 am
Saturday
Closed

COMPANY OVERVIEW

Join a company with values you can be proud of and a place where you can grow, be supported and reach your goals. Living our values every day is the reason people love working at DOXA - and it's all about Trust, Transparency, Inclusion, Excellence and Results. Together we can build culture of bayanihan with an eye toward lifting up our global community.
We care about you, your family, your community, and your wellbeing. The culture we provide as well as our competitive benefits are an investment in you as we strive to make an impact together.
Competitive PayWe are not a low-cost BPO because we believe in paying you what you are worth.
Premium BenefitsWe offer exceptional benefits to ensure you and your family have the coverage you need – from health plans and paid time off to daily meal subsidies. We treat your family as an extension of ours.
Flexible WFH OptionsWe give you the option to work from home or in the office. This gives the flexibility you need and allows you to spend what would be commuting time with your family and working towards your personal growth.
Culture Of ExcellenceWe have high expectations. Working with like-minded, driven people gives you the opportunity to learn from them, share knowledge, and lead alongside the best of the best.
Professional DevelopmentWe connect you with clients who share your same values and finding a role that encourages your strengths, you have the opportunity to realize your full potential and continue to grow.

Get to know us more. Please visit our website: www.doxa7.com

WHY JOIN US?

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