ICU Clinical Auditor
18 hours ago
At Go-Get Data Consultancy, we are seeking a detail-oriented and experienced ICU RN Auditor to review and assess medical records, coding accuracy, and documentation compliance in intensive care unit (ICU) settings. The ideal candidate will have a strong background in critical care nursing, medical auditing, and regulatory compliance to ensure adherence to healthcare standards and best practices.
Key Responsibilities- Conduct audits of ICU patient records to assess accuracy, completeness, and compliance with medical guidelines and policies.
- Evaluate documentation for proper coding, billing, and reimbursement alignment with healthcare regulations.
- Identify discrepancies, errors, and areas for improvement in ICU charting and clinical documentation.
- Collaborate with healthcare teams, physicians, and administrative staff to provide feedback and recommendations for documentation improvement.
- Ensure adherence to hospital policies, CMS guidelines, and other regulatory requirements.
- Minimum 5 years experience in Post Payment Claims Auditing or ICU RN Auditor and 5-10 years experience on ICU/CCU nursing experience.
- Exposed to ICU experience such as local/international bedside/hospital setting.
- Experience in ICU: reading patient's records, auditing, assessment, claims, appeals, denials.
- Understanding of ICD 9/10, CPT/HCPCS coding, DRG guidelines, correct coding initiative, revenue codes, modifiers, and APC reimbursement.
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ICU Nurse Specialist
2 days ago
Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeLinda Hausermann & Associates is committed to providing exceptional patient care, and we need talented professionals like you to help us achieve this goal. As an ICU RN Auditor, you will play a critical role in ensuring the accuracy and integrity of our clinical data.The successful candidate will have a solid foundation in nursing, with a minimum of 5 years...
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Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeJob Details:We are seeking a highly skilled ICU RN Auditor to support the review and analysis of patient data, ensuring compliance with regulatory guidelines and industry standards.Main Responsibilities:Conduct thorough audits of patient records to identify potential issues and areas for improvementCollaborate with healthcare professionals to address...
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Clinical Quality Assurance RN
2 days ago
Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeWe are seeking an experienced Clinical Quality Assurance RN to join our team at Linda Hausermann & Associates. As an ICU RN Auditor, you will be responsible for monitoring and improving the quality of patient care in our intensive care units.The ideal candidate will have a strong background in nursing, with at least 5 years of experience in post-payment...
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Auditor and Registered Nurse
2 days ago
Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeLinda Hausermann & Associates is a leading provider of healthcare services, and we are committed to hiring the best talent in the industry. As an Auditor and Registered Nurse, you will play a vital role in ensuring the accuracy and integrity of our clinical data.The successful candidate will have a solid foundation in nursing, with a minimum of 5 years of...
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Intensive Care Unit Registered Nurse Auditor
21 hours ago
Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeJob Overview:Linda Hausermann & Associates seeks a skilled Intensive Care Unit Registered Nurse Auditor to join our team. The ideal candidate will possess strong clinical knowledge, excellent analytical skills, and the ability to effectively communicate with healthcare professionals.Salary Information:The salary for this position is PHP 70,000 - PHP 80,000...
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Medical Auditor
2 days ago
Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeAt Linda Hausermann & Associates, we are seeking an experienced Medical Auditor to join our team. As an ICU RN Auditor, you will be responsible for ensuring the highest quality of patient care in our intensive care units.The ideal candidate will have a strong background in nursing, with at least 5 years of experience in post-payment claims auditing or as an...
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Post Payment Claims Audit Specialist
21 hours ago
Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeJob Summary:Linda Hausermann & Associates is seeking a highly experienced ICU RN Auditor to lead the development and implementation of auditing protocols, ensuring accuracy and efficiency in patient care reimbursement.Duties and Responsibilities:Design and execute comprehensive auditing strategies to identify areas for improvementCollaborate with...
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Critical Care Nursing Expert
18 hours ago
Taguig, National Capital Region, Philippines Go-Get Data Consultancy Full timeAs a Medical Record Analyst at Go-Get Data Consultancy, you will be responsible for reviewing and assessing medical records, coding accuracy, and documentation compliance in ICU settings. This is a challenging role that requires a strong background in critical care nursing, medical auditing, and regulatory compliance.ResponsibilitiesConduct audits of ICU...
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Taguig, National Capital Region, Philippines Linda Hausermann & Associates Full timeAbout the Role:We are looking for a seasoned ICU RN Auditor to oversee the review and analysis of patient data, ensuring compliance with regulatory guidelines and industry standards.Key Responsibilities:Conduct thorough audits of patient records to identify potential issues and areas for improvementCollaborate with healthcare professionals to address...
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Clinical Experience Specialist
4 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeGratitude Philippines is seeking a skilled Clinical Experience Specialist to join our team. The successful candidate will have a Bachelor's degree in nursing (BSN) and an active, unrestricted RN license that can be validated through the PRC website.This role requires 1-2 years of relevant clinical experience in medical/surgical departments, including...
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RN Healthcare Specialist
18 hours ago
Taguig, National Capital Region, Philippines Go-Get Data Consultancy Full timeWe are looking for a skilled ICU RN Auditor to join our team at Go-Get Data Consultancy. As an ICU RN Auditor, you will play a crucial role in reviewing and assessing medical records, ensuring coding accuracy, and promoting documentation compliance.About the RoleThis is a hybrid position working in Taguig, requiring flexibility and adaptability.The ideal...
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Clinical Nurse Consultant
2 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeClinical Nurse Consultant Job DescriptionWe are looking for an experienced and empathetic Clinical Nurse Consultant to join our team at Gratitude Philippines. As a key member of our healthcare team, you will provide expert guidance and support to injured employees, employers, and medical providers to achieve optimal return-to-work outcomes.Responsibilities...
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Medical Record Analyst
18 hours ago
Taguig, National Capital Region, Philippines Go-Get Data Consultancy Full timeGo-Get Data Consultancy is seeking a Critical Care Nursing Expert to join our team as an ICU RN Auditor. As a Critical Care Nursing Expert, you will play a crucial role in reviewing and assessing medical records, ensuring coding accuracy, and promoting documentation compliance in ICU settings.About the RoleThis is a hybrid position working in Taguig,...
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Clinical Classification Expert
4 days ago
Taguig, National Capital Region, Philippines R1 RCM Full timeAs a Clinical Classification Expert, you will play a crucial role in delivering accurate medical data classification in our fast-paced healthcare environment.You will possess a Medical Coding Certification (CPC, COC, CCS, or CCS-P) and at least 2+ years of OP coding experience.Previous experience in Charge Capture/Charge Audit, OP QA, or Auditor roles is...
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Medical Case Manager
4 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeAt Gratitude Philippines, we value expertise and dedication. Our Utilization Reviewer position requires a highly qualified professional with a deep understanding of clinical experience and case management practices. As a Clinical Experience Specialist, you will leverage your knowledge to support informed decision-making within our organization.The successful...
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Utilization Review and Improvement Expert
4 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeWe are looking for a seasoned Utilization Review and Improvement Expert to join our team at Gratitude Philippines. This role demands a high level of proficiency in analyzing and managing complex cases, leveraging extensive knowledge of medical procedures, regulatory compliance, and best practices in healthcare.The successful candidate will bring a unique...
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Medical Case Manager Specialist
2 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob SummaryWe are seeking a highly skilled Medical Case Manager to join our team at Gratitude Philippines. As a key member of our healthcare team, you will be responsible for coordinating the return-to-work process for injured workers, ensuring timely and effective medical treatment, and promoting optimal outcomes.This role requires strong clinical...
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Utilization Reviewer
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeRequired Qualifications:• Bachelor's degree in nursing (BSN)• Active unrestricted RN license that can be validated thru PRC website• 1-2 years of relevant Clinical experience in any medical/surgical department, Orthopedic, Medical/Surgical ICU, Coronary Care Unit (CCU), Rehabilitation, Emergency department• Written and verbal fluency in English•...
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Utilization Reviewer
3 weeks ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeRequired Qualifications:• Bachelor's degree in nursing (BSN)• Active unrestricted RN license that can be validated thru PRC website• 1-2 years of relevant Clinical experience in any medical/surgical department, Orthopedic, Medical/Surgical ICU, Coronary Care Unit (CCU), Rehabilitation, Emergency department• Written and verbal fluency in English•...
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Utilization Reviewer
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeRoles and Responsibilities:• PH Nurses to review treatment authorization request based on state guidelines and medical necessity and take decision to approve/deny. In case of denial send this to independent panel review to support the decision. Nurses will work with Claims adjuster on denial decision based on risk tolerance to ensure the denial doesn't...