Quality Assurance Health care Urgent

Gratitude Inc

26 Views

1 day ago

Quality Assurance Health care Urgent

2-13 Year(s)

Manila (Makati)

Job Description

Key Skills

Quality Assurance/QA US Healthcare Medical Account for clerical or administrative support; active PHRN and USRN license

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Job Title: Quality Assurance
Account: Healthcare
Salary: 80K - 120K
Work location/Set up: TP Alphaland
Shift Schedule: GY
HC: 2

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."

*** Recruitment Process: ***
**Validation
Interview
2 assessments
Client-specific assessment
Initial interview with Ops
Final Interview with Ops**

Pre-Screening Notes:
Educational Attainment:
Years of Experience in Medical Accounts for clerical or administrative support:
USRN License: What is the validity?
Years of Experience as a QA
Last Drawn Salary:
Expected Salary:

Role

Any Other

Timings

Night Shift (Permanent)

Industry

BPO

Work Mode

Work from office

Functional Area

Any Other

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