Us Registered Nurse (Wfh W/ 100K Signing Bonus)

**Duties and Responsibilities**:

- Conduct UM pre-service, concurrent, retrospective, out of network, and appropriateness of treatment setting.
Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts.
- Accurately routes cases to client medical staff for further review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
- Responsible for conducting medical management review activities which require the review of clinical information against client specific criteria as noted above, but excludes denial determinations.
- Process incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for pre-certification and/or prior authorization.
Verify benefits and/or eligibility information.
Check benefits for facility-based treatment.
**Minimum Qualifications**:

- Must have at least 1 year hospital experience as a Registered Nurse
- Must have an active USRN License

**Job Types**: Full-time, Permanent

**Salary**: Php40,000.00 - Php65,000.00 per month

**Benefits**:

- Additional leave
- Employee stock ownership plan
- Health insurance
- Life insurance
- Opportunities for promotion
- Paid training
- Pay raise
- Work from home

Schedule:

- 8 hour shift
- Night shift

Supplemental Pay:

- 13th month salary
- Bonus pay
- Overtime pay
- Performance bonus

Application Question(s):

- Do you have an active US License?
Which state?
- How long is your hospital experience?