Medical Records Review Nurse (Workers' Compensation)

HireUs.PH OPC; Metro Manila; Remote; PHP 420,000 - 620,000; Full time

Job summary

HireUs.PH OPC is hiring a Medical Records Review Nurse to analyze medical records, summarize data, and support legal, insurance, or healthcare case reviews. The role emphasizes attention to detail, familiarity with US standards, and prior remote or BPO healthcare experience.

Responsibilities include creating medical chronologies, identifying gaps, tracking progress, and preparing summaries for attorneys and adjusters. Remote work from the Philippines with flexible scheduling supported.

Qualifications

• US nursing license or NCLEX (a big plus and shows familiarity with US standards)
• Experience in US workers' compensation, insurance, medical-legal, or personal injury work
• Experience with utilization review, case management, or medical billing/coding (ICD-10, CPT)
• Familiarity with workers' comp concepts such as IMEs, MMI, impairment ratings, work restrictions, and return-to-work
• Knowledge of treatment guidelines like ODG or state-specific ones (e.g., CA MTUS)
• HIPAA training or certification
• Previous remote work or BPO healthcare account experience

Responsibilities

• Reviewing and summarizing medical records, creating medical chronologies
• Identifying treatment gaps, pre-existing conditions, and inconsistencies in records
• Tracking treatment progress, work status, and restrictions
• Preparing summaries for attorneys, adjusters, or case managers
• Communicating with medical providers' offices to request records or clarify information
• Maintaining accurate case notes in a case management system

Skills

Attention to detail

Analytical thinking

Confidentiality

Self-directed

Time management

Google Workspace

Microsoft 365

Zoom

Case management

Tools

Case management software

Job description

Location: Philippines - Work From Home

Type: Full Time

Schedule: 5-6 days, 8 hours each (Mon, Tue, Wed, Thu, Fri) 08:00 - 17:00 (MST)

Description

We are seeking a detail-oriented and experienced Medical Records Review Nurse to review, analyze, and organize medical records to ensure accuracy, completeness, and proper documentation. The successful candidate will use their clinical knowledge and attention to detail to identify relevant medical information, summarize records, and support legal, insurance, or healthcare-related case reviews.

Responsibilities

• Reviewing and summarizing medical records, creating medical chronologies
• Identifying treatment gaps, pre-existing conditions, and inconsistencies in records
• Tracking treatment progress, work status, and restrictions
• Preparing summaries for attorneys, adjusters, or case managers
• Communicating with medical providers' offices to request records or clarify information
• Maintaining accurate case notes in a case management system

Qualifications

• US nursing license or passed NCLEX (a big plus and shows familiarity with US standards)
• Prior experience in US workers' compensation, insurance, medical-legal, or personal injury work
• Experience with utilization review, case management, or medical billing/coding (ICD-10, CPT)
• Familiarity with workers' comp concepts such as IMEs, MMI (maximum medical improvement), impairment ratings, work restrictions, and return-to-work/light duty
• Knowledge of treatment guidelines like ODG or state-specific ones (e.g., California MTUS)
• HIPAA training or certification
• Previous remote work or BPO healthcare account experience

Skills

Strong attention to detail and analytical thinking, Ability to handle confidential information with discretion, Organized, self-directed, and able to meet deadlines independently, Comfortable with tools like Google Workspace or Microsoft 365, Zoom, and case management software

Experience

At least 2–3 years of hospital or clinical nursing experience (ER, orthopedics, surgical, rehab, or occupational health)