Clinical Operations Specialist

1 week ago


Pasig, National Capital Region, Philippines Solid Lyndelle Manpower Services Inc. Full time

**Job Overview**

Solid Lyndelle Manpower Services Inc. is seeking an experienced Clinical Operations Specialist to join our team.

About the Role:

We are looking for a highly skilled Clinical Operations Specialist to work on-site, Monday to Friday. As a Clinical Operations Specialist, you will be responsible for performing regular audits of clinical practices, patient records, and healthcare processes.

Key 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 requirements.
  • Develop educational materials and resources to support ongoing staff development.

Requirements:

To be successful in this role, you will need:

  • A Registered Nurse qualification with CIC/CCS certification.
  • 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.
  • General knowledge of medical procedures, conditions, illnesses, and treatment practices.
  • Excellent written and verbal communication skills.
  • Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency.
  • Excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.

What We Offer:

We offer a competitive salary range of $50,000-$90,000 per year, depending on experience.



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