Clinical Review RN: Data-Driven Healthcare Specialist

EXL Talent Acquisition Team; Pasay; In loco; PHP 240.000 - 360.000; Tempo pieno

Descrizione del lavoro

EXL is seeking a Registered Nurse to review and evaluate clinical information, perform fax triage and conversion, and assist provider calls. The role emphasizes applying clinical criteria and policies in line with regulatory standards while protecting patient confidentiality.

Ideal candidates hold an active PRC - RN license with at least 1 year of hospital bedside experience and are comfortable navigating multiple healthcare IT systems within a dynamic environment.

Competenze

• Active PRC - RN License.
• Minimum 1 year hospital bedside experience.

Mansioni

• Review and evaluate clinical information and documentation, fax triage and conversion, and provider calls.
• Review documentation and interpret data from clinical records or systems to apply clinical criteria and policies in line with regulatory and accreditation requirements.
• Protect the confidentiality of member information and adhere to company policies regarding confidentiality.
• Data gathering requires navigation through multiple system applications.

Conoscenze

RN License

Bedside experience

Descrizione del lavoro

EXL is seeking a Registered Nurse to review and evaluate clinical information, perform fax triage and conversion, and assist provider calls. The role emphasizes applying clinical criteria and policies in line with regulatory standards while protecting patient confidentiality.

Ideal candidates hold an active PRC - RN license with at least 1 year of hospital bedside experience and are comfortable navigating multiple healthcare IT systems within a dynamic environment.