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Job Title: Quality Assurance

Gratitude Inc
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1 month ago

Job Title: Quality Assurance

2-5 Year(s)
Manila (Makati)
Manila (Makati)

Job Description

Key Skills

USRN QA SKILLS * Above average communication skills Proficiency in MS Office reviewing medical data or documentation Medical Account for clerical or administrative support;

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Key Responsibilities :

•Review and verify medical reports for accuracy
•Maintain and update documentation systems
•Handled communications with stakeholders
•Monitor compliance with healthcare regulations

Non-Negotiable Requirements:
• PH Registered Nurse
• Registered Nurse with current, unrestricted US Registered Nurse license w/ BPO Experience and QA Experience
• Minimum 2 years of clinical bedside experience (ER, ICU, Med-Surg, Telemetry preferred).
• Minimum 1 year of USRN BPO or U.S. Healthcare experience in UM, CM, Appeals, Triage, or related clinical processes.
• Knowledge of MCG/Milliman, InterQual, clinical guidelines, HIPAA requirements, and U.S. medical terminology.
• Prior experience as a Quality Analyst, Clinical Auditor, or Clinical Reviewer in a U.S. healthcare account.
• Strong analytical skills with high attention to detail and documentation accuracy.
• At least one (1) year of experience in medical account for clerical or administrative support; someone experienced in handling or reviewing medical data or documentation
• Excellent English communication skills both verbal and written; must be comfortable in taking phone calls and high-volume emails.
• Ability to stay focused and adaptable under pressure and shifting priorities
• Knowledgeable in US Healthcare Law and Care Coordination
• Familiarity with coding systems (ICD-10, CPT) is a plus.
• Strong proficiency in MS Office tools and QA evaluation systems."


Role

Medical Administrator

Timings

Rotational Shifts (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Work from office

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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Jane E Nwafor

Recruiter - Gratitude Inc

NA, nigeria

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