Clinical Appeals Quality Auditor

Health Business Solutions LLC; Cebu City; On-site; PHP 40,000 - 50,000; Full time

Benefits offered by this job

Career development opportunities

Competitive salary and benefits

Collaborative environment

Job summary

A healthcare solutions provider in Cebu City is seeking a Clinical Quality Auditor to ensure the integrity of clinical appeals. The role involves auditing documents for compliance with guidelines and policies, utilizing tools like Atlas and Epic. Candidates must have at least one year at Hbiz Solutions and a Bachelor’s in Nursing. This is a great opportunity for professional growth in a collaborative environment, with competitive compensation and potential for career advancement.

Qualifications

• Active employment at Hbiz Solutions as a Clinical Appeals Specialist for at least 1 year.
• Three years work experience as a Registered Nurse in a hospital or equivalent clinical setting.
• Strong understanding of clinical trial protocols and healthcare regulatory requirements.

Responsibilities

• Conduct audits of clinical appeals for compliance.
• Utilize tools to ensure accurate data in completed appeals.
• Maintain and update audit findings, documenting corrective actions.

Skills

Clinical operations understanding

Detail-oriented

Organizational skills

Communication skills

Problem-solving skills

Education

Bachelor’s of Science in Nursing

Tools

Qodex

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

A healthcare solutions provider in Cebu City is seeking a Clinical Quality Auditor to ensure the integrity of clinical appeals. The role involves auditing documents for compliance with guidelines and policies, utilizing tools like Atlas and Epic. Candidates must have at least one year at Hbiz Solutions and a Bachelor’s in Nursing. This is a great opportunity for professional growth in a collaborative environment, with competitive compensation and potential for career advancement.