(ACTIVE) US Registered Nurse (South Carolina Account) Hybrid/TWFH | W/ SOB

Gratitude Inc

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4 hours ago

(ACTIVE) US Registered Nurse (South Carolina Account) Hybrid/TWFH | W/ SOB

2-10 Year(s)

Cebu Central Visayas, Manila

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Job Description

Key Skills

Consultation Analytical Skills USRN US Registered Nurse Utilization Management SURGICAL clinical experience Utilization Review .Risk Assessment Health Insurance Claims Processor Patient Care Attention to detail Bill Review Surgical experience in hospital setting nurse auditing

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Job Title: US Registered Nurse

Account: South Carolina
Location: Taguig / Cebu
Start Date: October
Work Setup: Onsite Training; Hybrid / TWFH after training
Work Schedule: Shifting
Sign-on Bonus: PHP 100,000

Job Summary:
We are looking for an experienced US Registered Nurse to support the South Carolina account. The role involves clinical review, nurse auditing, utilization review, bill review, and complex medical case management activities. Candidates must have an active USRN license and relevant clinical experience.

Key Responsibilities:
• Perform nurse auditing, utilization review, and medical bill review activities.
• Review and assess clinical cases based on established guidelines and requirements.
• Support complex medical, legal, and consultation reviews.
• Apply clinical knowledge to evaluate medical documentation and case information.
• Review surgical and clinical information accurately and identify relevant medical details.
• Maintain accurate documentation and ensure quality and compliance in all assigned activities.
• Collaborate with internal teams and stakeholders to resolve clinical queries.
• Follow account-specific processes, quality standards, and operational requirements.
• Successfully complete validation, HR interview, hiring manager interview, and onboarding requirements.

Required Qualifications:
• Active US Registered Nurse license from any mainland US state.
• Minimum 2 years of recent surgical experience in a hospital setting, OR 2+ years of clinical case management experience with additional complex medical, legal, and consultation review preferred.
• Minimum 2 years of experience in daily nurse auditing, utilization review, and bill review.
• Strong clinical assessment, analytical, and documentation skills.
• Good communication skills and ability to work in a professional environment.
• Willingness to work in shifting schedules.
• Willingness to undergo onsite training and transition to Hybrid/TWFH after training.

Recruitment Process:
Validation
Talkpush Profile Creation
HR Interview
Hiring Manager Interview
Onboarding

Screening Requirements:
• Current location and preferred work site
• Active USRN license and validity date
• Years of surgical experience in a hospital setting
• Years of clinical case management experience
• Years of nurse auditing, utilization review, and bill review experience
• Last drawn salary
• Salary expectations
• Availability to start in October

Role

US Registered Nurse

Timings

Rotational Shifts (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Hybrid

Process

Non-Voice

Functional Area

ITES / BPO / Customer Service

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