QA - Clinical Services

HRTX; Taguig; On-site; PHP 446,400 - 669,600; Full time

Benefits offered by this job

Collaborative team environment

Career development and learning opportunities

Job summary

A reputable healthcare BPO provider in Taguig seeks a professional with 2 to 5 years of experience in Clinical Authorization or Utilization Review. The role involves conducting utilization reviews and ensuring accurate clinical authorization processes, requiring strong attention to detail and communication skills. Familiarity with EPIC, MCG, or InterQual is preferred. The position offers career development opportunities in a collaborative environment with a night shift schedule.

Qualifications

• 2 to 5 years of hands-on experience in Clinical Authorization or Utilization Review is required.
• Prior experience as a Quality Auditor in Clinical Services within a healthcare BPO is a strong plus.
• Familiarity with EPIC, MCG, or InterQual is preferred, but not required.

Responsibilities

• Ensure accurate clinical authorization processes.
• Conduct utilization reviews to support healthcare services.

Skills

Clinical Authorization

Utilization Review

Quality Auditor

Attention to detail

Excellent communication skills

Tools

EPIC

MCG

InterQual

Job description

2 to 5 years of hands-on experience in Clinical Authorization or Utilization Review (required)

Prior experience as a Quality Auditor in Clinical Services within a healthcare BPO setting (a strong plus)

Familiarity with EPIC, MCG, or InterQual (preferred, not required)

Strong attention to detail and excellent communication skills

Consistent employment history with minimal job transitions

Schedule & Work Setup

• Onsite position (McKinley West, Taguig)
• Night shift

Why Join Us?

• Work with a reputable healthcare BPO provider
• Collaborative team environment
• Career development and learning opportunities