Clinical Auditor

5 months ago


Pasig, Philippines Gratitude Philippines Full time

Job DescriptionResponsibilities:Perform regular audits of clinical practices, patient records, and healthcare processes.Analyze audit findings and data to identify trends, patterns, and areas of risk.Monitor the effectiveness of implemented changes and provide ongoing support.Ensure that the organization complies with all relevant regulatory requirements.Develop educational materials and resources to support ongoing staff development.Required Skills:Registered Nurse with CIC/CCS certification and prior auditing/DRG experience preferred.Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred.Possesses knowledge of healthcare claims payment policy and processing – specifically CMS, Medicaid regulations, ICD-10 CM & DRG Expert, etc.Practical clinical experience working in a hospital/office or nursing home.Has general knowledge of medical procedures, conditions, illnesses, and treatment practices.Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency.Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.



  • Cebu and Pasig, Philippines Solid Lyndelle Manpower Services Inc. Full time

    Clinical Audit Expert Job OpportunityAt Solid Lyndelle Manpower Services Inc., we are seeking a skilled Clinical Auditor to join our team. This role involves performing regular audits of clinical practices, patient records, and healthcare processes.Responsibilities:Conduct thorough audits to ensure compliance with regulatory requirements and identify areas...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Job Title: Senior Clinical Nurse Auditor SpecialistWe are seeking a highly skilled Senior Clinical Nurse Auditor Specialist to join our team at Visaya KPO.About the RoleIn this critical role, you will work closely with our Eligibility Enrollment Specialist to obtain referrals from Savista's client. Your expertise in medical records and authorization...

  • Clinical Nurse Auditor

    4 months ago


    Pasig, Philippines Visaya KPO Full time

    Key Responsibilities Works with the Eligibility Enrollment Specialist to obtain referrals from Savista’s client Review medical records to validate what authorization is required Utilize Savista’s client’s host system to document case and updated account statuses when applicable Utilize state or payor portal to check authorization...

  • Clinical Nurse Auditor

    4 months ago


    Pasig, Philippines Visaya KPO Full time

    Key Responsibilities Works with the Eligibility Enrollment Specialist to obtain referrals from Savista’s client Review medical records to validate what authorization is required Utilize Savista’s client’s host system to document case and updated account statuses when applicable Utilize state or payor portal to check authorization...

  • Clinical Nurse Auditor

    2 months ago


    Pasig, Philippines Visaya Knowledge Process Outsourcing Full time

    "Key Responsibilities Works with the Eligibility Enrollment Specialist to obtain referrals from Savista’s client Review medical records to validate what authorization is required Utilize Savista’s client’s host system to document case and updated account statuses when applicable Utilize the state or payor portal to check authorization statuses" ...

  • Clinical Nurse Auditor

    2 months ago


    Pasig, Philippines Visaya Knowledge Process Outsourcing Full time

    "Key Responsibilities Works with the Eligibility Enrollment Specialist to obtain referrals from Savista’s client Review medical records to validate what authorization is required Utilize Savista’s client’s host system to document case and updated account statuses when applicable Utilize the state or payor portal to check authorization...

  • Clinical Nurse Auditor

    4 months ago


    Pasig City, Philippines Visaya KPO Full time

    Key Responsibilities Works with the Eligibility Enrollment Specialist to obtain referrals from Savista’s client Review medical records to validate what authorization is required Utilize Savista’s client’s host system to document case and updated account statuses when applicable Utilize state or payor portal to check authorization statusesEducation:...

  • Clinical Nurse Auditor

    2 months ago


    Pasig City, Philippines Visaya Knowledge Process Outsourcing Full time

    "Key Responsibilities Works with the Eligibility Enrollment Specialist to obtain referrals from Savista’s client Review medical records to validate what authorization is required Utilize Savista’s client’s host system to document case and updated account statuses when applicable Utilize the state or payor portal to check authorization statuses"...

  • Clinical Auditor

    5 months ago


    Cebu and Pasig, Philippines Gratitude Philippines Full time

    Job Description Responsibilities: Perform regular audits of clinical practices, patient records, and healthcare processes. Analyze audit findings and data to identify trends, patterns, and areas of risk. Monitor the effectiveness of implemented changes and provide ongoing support. Ensure that the organization complies with all relevant regulatory...

  • Clinical Auditor

    5 months ago


    Cebu and Pasig, Philippines Gratitude Philippines Full time

    Job Description Responsibilities: Perform regular audits of clinical practices, patient records, and healthcare processes. Analyze audit findings and data to identify trends, patterns, and areas of risk. Monitor the effectiveness of implemented changes and provide ongoing support. Ensure that the organization complies with all relevant regulatory...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Job Title: Healthcare Authorization SpecialistAbout the Job:We are seeking a skilled Clinical Nurse Auditor to join our team at Visaya Knowledge Process Outsourcing. As a key member of our authorization team, you will be responsible for working closely with our Eligibility Enrollment Specialists to obtain referrals from clients, reviewing medical records to...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Visaya Knowledge Process Outsourcing is seeking a skilled Clinical Nurse Auditor to join our team. This role involves working closely with the Eligibility Enrollment Specialist to secure referrals from Savista's clients.The ideal candidate will have a strong understanding of clinical authorizations, medical records, and customer service skills. A Bachelor's...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Job DescriptionWe are seeking a skilled and detail-oriented Clinical Nurse Auditor to join our team at Visaya Knowledge Process Outsourcing. As a key member of our healthcare compliance team, you will play a critical role in ensuring the accuracy and integrity of medical records.Key Responsibilities:Collaborate with Eligibility Enrollment Specialists to...