Taguig, Metro Manila, Philippines
Full-Time
On-Site

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Utilization & Denials Management Supervisor
Utilization & Denials Management Supervisor

Job Description:

Discover your 100% YOU with MicroSourcing!

Position: Utilization & Denials Management Supervisor

Location: BGC, Taguig City

Work setup & shift: Onsite, Night shift

Why join MicroSourcing

Competitive Rewards

Enjoy above-market compensation, healthcare coverage on day one for you and your dependents, paid time-off with cash conversion, group life insurance, and performance bonuses.

A Collaborative Spirit

Be part of a positive and engaging work environment through company-sponsored events and activities.

Work-Life Harmony

Experience a balance that suits your lifestyle with flexible work arrangements.

Career Growth

Access continuous learning opportunities and career advancement.

Inclusive Teamwork

Join a diverse and inclusive workplace that values every individual's contribution.

Your Role

As a Utilization & Denials Management Supervisor, you will oversee daily production, clinical review processes, and quality functions to ensure operational efficiency and compliance.

You Will:

Supervise and support Clinical Denials, Appeals, and Utilization Review (UR) staff, including hiring, onboarding, and performance management
Monitor daily workflows to ensure SLAs and KPIs are met, reallocating tasks to manage high-risk cases and prevent backlogs
Implement process improvements to reduce denials, write-offs, and clinical inefficiencies
Conduct audits and quality reviews to ensure compliance with payer regulations and clinical standards
Collaborate with HIM, Revenue Integrity, Coding, and Billing teams to ensure clean claim generation and system optimization
Report team performance in operations meetings and provide ongoing education on documentation updates and audit findings
Coordinate with healthcare professionals to ensure accurate and timely clinical documentation

Non-negotiables:

What You Need

Supervisory Experience: At least 1 year in utilization management and/or clinical denials and appeals supervision
Clinical Experience: 3–5 years acute care hospital experience (Med/Surg preferred) or 2–3 years ICU experience
Education & License: Bachelor of Science in Nursing with active PHRN or USRN license
RCM Knowledge: Strong understanding of InterQual or MCG guidelines and US insurance and government healthcare regulations
Systems: Experience with EMRs such as Epic, Cerner, or Meditech
Communication: Excellent English communication skills (minimum CEFR B2)

Preferred Skills

Education: Master's degree or related healthcare/business qualification
Certification: Case management or clinical appeals/denials certification (e.g., ACMA)
Leadership: Proven ability to lead in a matrixed environment and influence stakeholders
Technical Skills: Proficiency in tracking tools for authorizations and Microsoft Office Suite
Soft Skills: Strong analytical thinking, sound judgment, and decision-making abilities

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the Philippines pioneer and largest offshore provider of managed services.

We believe our strength lies in our people. Our commitment to 100% YOU means fostering a culture that values diversity, inclusion, and authenticity. Here, individuality is celebrated, and growth is supported.

Join us in celebrating YOU and your 100%.

For more information, visit https://www.microsourcing.com/

Terms & conditions apply

Apply nowRefer

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Job Openings
Utilization & Denials Management Supervisor
Utilization & Denials Management Supervisor