job description
Are you a Medicine graduate or undergrad with a passion for healthcare optimization? eData Services Philippines Inc. is expanding its remote workforce and seeking dedicated Utilization Review Physicians to join our team in Bali, Indonesia.
In this role, you will play a critical part in ensuring efficient and appropriate healthcare resource allocation by reviewing medical cases, assessing treatment plans, and collaborating with healthcare providers. This is a unique opportunity to leverage your medical knowledge in a dynamic, remote-friendly environment while contributing to high-impact healthcare decisions.
Whether you’re based in Canggu, Ubud, Denpasar, or any of Bali’s vibrant hubs, this position offers the flexibility to work from paradise while advancing your career in healthcare management and utilization review.
Responsibility
- Conduct thorough medical necessity reviews for insurance claims, hospital admissions, and treatment plans.
- Collaborate with healthcare providers, insurers, and case managers to ensure compliance with medical policies and guidelines.
- Analyze patient records, diagnostic reports, and treatment histories to determine appropriate care levels.
- Document and communicate review findings clearly and professionally to stakeholders.
- Identify potential overutilization or underutilization of medical services and recommend cost-effective alternatives.
- Stay updated on medical coding standards (ICD-10, CPT) and healthcare regulations.
- Participate in peer reviews and quality assurance processes to maintain high standards.
- Provide clinical expertise in interdisciplinary team meetings to resolve complex cases.
Qualifications
- Bachelor’s degree in Medicine (MD) or equivalent; undergrads with relevant experience are encouraged to apply.
- Valid medical license (or eligibility for licensure) in the Philippines or equivalent jurisdiction.
- Minimum 1-2 years of clinical experience (internship, residency, or practice) preferred.
- Familiarity with healthcare utilization review, case management, or insurance processes is a plus.
- Strong analytical, communication, and documentation skills.
- Proficiency in English (written and verbal); additional languages are a bonus.
- Ability to work independently in a remote setting with reliable internet access.
- Detail-oriented with a commitment to ethical and accurate medical assessments.