Clinical Nurse Auditor

Now Hiring: Clinical Audit Supervisor (RN, BSN)Onsite | Night Shift | IloiloOur client is seeking an experiencedClinical Audit Supervisorto provide strategic and operational leadership to Clinical Nurse Auditors and Coding Denials Auditors, while remaining hands-on with complex clinical audits.This role supports accurate reimbursement, regulatory compliance,...

KAVI Philippines seeks the Clinical Audit Supervisor. This role provides strategic and operational leadership to Clinical Nurse Auditors and Coding Denials Auditors while maintaining an active hands-on audit function. The Clinical Audit Supervisor ensures consistent application of medical review standards, audit methodology, and regulatory compliance across...

The Prior Authorization Clinical Specialist – US RN is responsible for providing clinical expertise and operational support in the prior authorization and utilization management process for U.S. healthcare payers. This role ensures medical necessity determinations are accurate, compliant, and timely by applying clinical judgment, payer policies, and...

The Medical City Iloilo is seeking a dedicated and highly skilledEmergency Room (ER) Staff Nursewho will play a crucial role in delivering prompt, safe, and high-quality nursing care to patients with urgent and life-threatening conditions. This role supports rapid assessment, immediate interventions, and coordinated emergency response in a dynamic,...

The Medical City Iloilo is looking for adedicated and highly skilled Recovery Room Staff Nursewho will play a vital role in providing safe, timely, and high-quality nursing care to patients immediately following surgical procedures. This role supports patient stabilization, monitoring, and post-anesthesia recovery in a fast-paced perioperative...

Job Description:We are seeking a detail-oriented, knowledgeable, and proactive Clinical Quality Auditor to help ensure the integrity and quality of our clinical appeals. As an internal team member, you'll have the advantage of already being familiar with our processes and culture, making you an ideal candidate for this role. In this position, you will audit...

Job DescriptionResponsible for reviewing medical information to determine if requested treatment is medically necessary and appropriate according to the given standards.ResponsibilitiesEvaluation of Medical InformationAnalyzes medical information and applies established criterion to facilitate the utilization review process.Collaborates objectively with peer...

The Medical City Iloilois seeking a qualifiedCardiac Catheterization Laboratory Staff Nursewho will play a pivotal role in delivering safe, efficient, and high-quality nursing care to patients undergoing cardiac catheterization and interventional cardiology procedures. This position is designed to support accurate diagnostics, timely interventions, and...

DescriptionResponsible for auditing in-patient and/or surgical bills to promote excellence in medical bill review and process improvement.ResponsibilitiesMedical Bill ReviewProcesses inpatient and/or surgical bills by adhering to the given standard operating procedures (SOP) and turnaround time to complete the task.Performs bill review process by utilizing...

Responsible for auditing in-patient and/or surgical bills to promote excellence in medical bill review and process improvement.Medical Bill ReviewProcesses inpatient and/or surgical bills by adhering to the given standard operating procedures (SOP) and turnaround time to complete the task.Performs bill review process by utilizing appropriate...