Job Title: Quality Assurance
Job Description
Key Skills
0 candidate(s) have already applied for this Job. Apply now
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
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
Similar Jobs
Technical Trainer (Ad Tech / Helpdesk Support)
Gratitude Inc2 - 5 Year(s)
₱ 30 - ₱ 40K p.m
Manila, Philippines
Now Hiring | Healthcare Account | Experienced CSR Wanted
Gratitude Inc0 - 1 Year(s)
₱ 20 - ₱ 27K p.m
Manila, Philippines
Quality Assurance - Healthcare
Gratitude Inc1 - 2 Year(s)
₱ 15 - ₱ 20K p.m
Manila, Philippines
Job Title: Clinical Team Manager | Healthcare
Gratitude Inc3 - 8 Year(s)
Confidential
Manila, Philippines
Clinical Team Manager | Healthcare
Gratitude Inc2 - 3 Year(s)
Confidential
Manila, Philippines
PHRN/USRN - Clinical Disability Claims
Gratitude Inc2 - 5 Year(s)
₱ 60 - ₱ 85K p.m
Manila, Philippines
PHRN/ USRN Healthcare - Clinical Disability Claims
Gratitude Inc1 - 2 Year(s)
Confidential
Manila, Philippines
Spanish Quality Auditor - RCM
Gratitude Inc1 - 2 Year(s)
₱ 45 - ₱ 50K p.m
Manila, Philippines
PHRN/USRN Healthcare Clinical Disability Claims (WFH)
Gratitude Inc2 - 5 Year(s)
Confidential
Manila, Philippines
USRN Clinician | Non-Voice
Gratitude Inc3 - 6 Year(s)
₱ 58 - ₱ 59.18K p.m
Manila, Philippines

