Remote US RN - Healthcare Auditing & Utilization Review

Level Up Business Process Outsourcing Services OPC; Cebu City; Remote; PHP 2,198,000 - 3,769,000; Full time

Job summary

Level Up Talent Solutions is seeking a Lean-Pro US Registered Nurse to support the South Carolina account in healthcare operations requiring strong clinical judgment, review accuracy, and experience in complex healthcare documentation.

This role supports nurse auditing, utilization review, bill review, and related clinical review processes with emphasis on quality and compliance, following account-specific guidelines.

Qualifications

• Active USRN license from any mainland U.S. state.
• 2 years of recent surgical hospital experience or 2 years in clinical case management.
• Experience with complex medical, legal, or consultation review preferred.
• 2+ years in nurse auditing, utilization review, and bill review.
• Strong clinical judgment and ability to review healthcare documentation accurately.
• Detail-oriented, organized, and able to follow structured account guidelines.
• Strong written communication and documentation skills.
• Ability to meet quality and productivity standards in healthcare operations.

Responsibilities

• Review healthcare-related cases, clinical records, or documentation based on account guidelines.
• Apply clinical judgment when supporting nurse auditing, utilization review, and bill review processes.
• Assess records for completeness, accuracy, medical relevance, and process alignment.
• Support review of complex medical, legal, or consultation-related documentation when assigned.
• Maintain quality, productivity, compliance, and turnaround-time expectations.
• Document findings, review outcomes, and required updates accurately.
• Escalate complex cases, documentation gaps, or process concerns when needed.
• Participate in training, calibration, and performance improvement activities.

Skills

Clinical judgment

Documentation skills

Quality focus

Attention to detail

Communication

Education

USRN license (Active)

Job description

Level Up Talent Solutions is seeking a Lean-Pro US Registered Nurse to support the South Carolina account in healthcare operations requiring strong clinical judgment, review accuracy, and experience in complex healthcare documentation.

This role supports nurse auditing, utilization review, bill review, and related clinical review processes with emphasis on quality and compliance, following account-specific guidelines.