Doctor – Utilization Reviewer
eData Services US, L.L.C. · Taguig
Job description
About the role
The Utilization Reviewer, a qualified medical doctor, evaluates the delivery of health services to ensure that patient care is appropriate, medically necessary, and of high quality. This role involves detailed review of clinical documentation and the application of approved guidelines and references.
Key responsibilities
- Assess medical records to verify that services align with patient needs and clinical standards.
- Abstract and analyze clinical data according to client‑specific guidelines and templates.
- Document findings clearly and accurately, highlighting any discrepancies or areas for improvement.
- Input approved guidelines and reference materials into the review system.
- Collaborate with healthcare providers and internal teams to resolve utilization issues.
Required profile
- Medical degree (MD or equivalent) with active licensure.
- Experience in clinical practice or medical record review.
- Strong analytical mindset and attention to detail.
- Excellent written communication skills for clear documentation.
Required skills
What we offer
- Full‑time employment with competitive monthly salary of ₱25,000‑₱30,000.
- Health and life insurance coverage.
- Paid training and opportunity for promotion to permanent employee.
- Transportation service provided.
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Published 1 day ago
Expires 1 month from now
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eData Services US, L.L.C.
Taguig