Aldrin
Registered Nurse, Prior Authorization, Utilization Management Review, Data Entry
Verified
Overview
Looking for 5 days a week work (8 hours/day)
at $6.56/hour ($1,272.74/month)
Bachelor's degree
Last Active
April 1st, 2026 (64 days ago)
Member Since
November 24th, 2010
Profile Description
Philippine Registered Nurse, with an expanded experience in the clinical and administrative field. Utilized 9+ years in utilization review/prior authorization in a US-based health insurance company and 5+ years as Intensive Care Unit nurse in the hospital setting. Guided with strong core values, quick to learn new systems, with ultimate goal for efficiency optimization, healthcare management and enhancing productivity and client-satisfaction, and collaborates with multidisciplinary teams to support insurance and therapeutic needs.
Top Skills
Customer Support » Healthcare
Experience: 5 - 10 years
Intensive Care Unit Nurse Key Responsibilities: Provided critical care to unstable patients, involving continuous monitoring, rapid assessment, and management of life support equipment Administered complex medications and performed routine ICU care Executed care plans with doctors and team Responded to emergencies requiring basic and advanced life support Discussed health plans and discharge instructions to patient and family members
Customer Support » Insurance » Prior Authorization
Experience: 5 - 10 years
Clinical Administrative Nurse Coordinator & Manager Key Responsibilities: Prior Authorization – reviewed medical coverage and benefits, issued administrative approval/denial per guidelines, review guides and SOPs, and prepared patient cases for further medical necessity review Validated data according to HIPAA compliance, including ICD-10, CPT, HCPCS codes used Requested clinical information to support the requested services Provided decision communication to providers and members via fax and/or calls, following US state requirements Educated providers and members on coverage and care options, and resource management in identifying alternatives, cost-effective treatments or service settings
Professional Services » Medical Services » HIPAA Compliance
Experience: 5 - 10 years
Other Skills
Customer Support » Insurance » Medical Insurance
Experience: 5 - 10 years
Office and Administration » Communication
Experience: 5 - 10 years
Office and Administration » Organization
Experience: 5 - 10 years
Basic Information
- Age
- 39
- Gender
- Male
- Website
- Sign Up with Pro Account to View
- Address
- Iligan City, Lanao del Norte
- Tests Taken
- DISC
- Dominance: 37%
- Influence: 6%
- Steadiness: 27%
- Compliance: 30%
- English
- C2(Advanced/Mastery)
- Government ID
- Sign Up with Pro Account to View
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