Job Title: Philippine Registered Nurse (PHRN)

Job Summary:

We are looking for a Philippine Registered Nurse (PHRN) to join our healthcare operations team. The ideal candidate is an active PRC-licensed Registered Nurse with BPO experience and strong clinical knowledge. This role supports US healthcare operations through medical record review, utilization management, case management, clinical documentation, or other healthcare support functions while ensuring compliance with client and regulatory standards.

Key Responsibilities:

• Review and analyze medical records, clinical documentation, and healthcare-related cases.
• Apply clinical knowledge to support healthcare operations, including utilization review, appeals and denials, case management, or medical coding support, depending on business needs.
• Ensure accuracy, quality, and compliance with client guidelines, HIPAA, and company policies.
• Communicate professionally with internal teams, healthcare providers, and other stakeholders as required.
• Maintain accurate documentation and complete assigned tasks within service level agreements (SLAs).
• Stay updated on healthcare regulations, clinical guidelines, and process changes.
• Meet productivity, quality, and attendance metrics.

Qualifications:

• Active Philippine Registered Nurse (PRC) license is required.
• At least 1–2 years of BPO healthcare experience.
• Clinical experience is an advantage but not required.
• Strong clinical assessment, analytical, and documentation skills.
• Excellent English communication skills, both written and verbal.
• Proficient in Microsoft Office and healthcare systems.
• Willing to work onsite on a permanent night shift schedule.
• Amenable to work in a fast-paced healthcare operations environment.