Utilization Reviewer - Doctor (Non-voice account)

About the role

The Utilization Reviewer – Doctor (Non‑voice) is responsible for evaluating the delivery of medical services to ensure they are appropriate, medically necessary, and of high quality. You will review patient documentation, abstract medical records, and apply client‑specific guidelines to confirm that care aligns with patient needs.

Key responsibilities

• Examine medical records and related documents to assess the appropriateness of care.
• Abstract and analyze clinical information according to established guidelines.
• Document findings using client‑provided templates and reference materials.
• Identify gaps or inconsistencies in care delivery and recommend corrective actions.
• Maintain accurate and confidential records of all reviews performed.

Required profile

• Medical background with a Doctor’s degree or equivalent clinical qualification.
• Strong understanding of utilization management principles and medical necessity criteria.
• Excellent attention to detail and analytical skills.
• Ability to work independently while adhering to strict timelines.

Required skills

What we offer

• Competitive monthly salary ranging from ₱25,000 to ₱30,000.
• Health and life insurance coverage.
• Paid training and opportunities for promotion to permanent employee.
• Transportation service provided.