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Coordinating Benefit Review Nurse at International SOS Government Medical Services

Pasig, Metro Manila, Philippines -

Full Time

Start Date

Immediate

Expiry Date

05 Jul, 26

Salary

0.0

Posted On

06 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization review, Clinical documentation review, Care management, Medical benefit review, Analytical skills, Customer service, MS Office, Communication skills, Healthcare service request evaluation

Industry

Medical Practices

Description

Job Title: Utilization Review Nurse (USRN Only - Dayshift)Description: About the RoleWe are looking for a Coordinating Benefits Review Nurse who will review healthcare service requests and determine coverage eligibility based on clinical criteria and U.S. Federal Employee Health Benefit (FEHB) Program policies. This role supports Japan-based US DoD Civilians and involves close collaboration with regional medical teams. Key Responsibilities Review and evaluate medical documentation based on established clinical guidelines and carrier policies. Ensure accuracy, efficiency, and quality in care management reviews. Coordinate with internal teams and Japan-based colleagues to obtain required case information. Maintain confidentiality and uphold ethical medical review standards. Support continuous improvement through data insights and collaboration. Qualifications Active Philippines Registered Nurse license (valid for at least 12 months). Active USRN License. Bachelor of Science in Nursing graduate. Minimum 2 years of clinical experience. Medical benefit review experience (URM) in a BPO supporting U.S. health insurance carriers (required). Strong communication, analytical, and customer service skills. Proficient in MS Office and able to navigate multiple systems. Job Details: 12 hours duty. (4 days duty, 3 days off) Morning Shift Work Onsite in Ortigas, Pasig Why join us? Be part of a global organization dedicated to providing exceptional medical and travel security services. Work in a dynamic and supportive environment. Opportunity to make a meaningful impact on the health and well-being of our clients.

Responsibilities

The Coordinating Benefit Review Nurse evaluates medical documentation to determine coverage eligibility based on clinical criteria and U.S. Federal Employee Health Benefit policies. They also coordinate with internal and regional medical teams to ensure accurate and efficient care management.