Remote USRN - SC Healthcare Audit & Utilization Review

Level Up Talent Solutions; Manila, Cebu City; Hybrid; PHP 1,008,000 - 1,386,000; Full time

Job summary

Level Up Talent Solutions is seeking a Lean-Pro US Registered Nurse to support the South Carolina account within a healthcare operations role requiring strong clinical judgment and accurate review of complex documentation.

The ideal candidate is an active USRN with recent surgical hospital or clinical case management experience, plus hands-on exposure to nurse auditing, utilization review, and bill review.

Qualifications

• Active USRN license from any mainland U.S. state.
• At least 2 years of recent surgical hospital experience or 2 years in clinical case management.
• Experience with complex medical, legal, or consultation review is preferred.
• At least 2 years of nurse auditing, utilization review, and bill review experience.

Responsibilities

• Review healthcare-related cases and documentation according to account guidelines.
• Apply clinical judgment in 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, outcomes, and required updates accurately.
• Escalate complex cases or documentation gaps when needed.
• Participate in training, calibration, and performance improvement activities.

Skills

USRN license

Clinical judgment

Detail oriented

Written communication

Job description

US Registered Nurse (South Carolina Account)

Manila and Cebu, Philippines | Posted on 09/14/2026

At Level Up Talent Solutions, we believe great work starts with feeling supported, trusted, and valued.

We are a people-focused talent company that connects skilled professionals with meaningful long-term opportunities. Our goal is to create an environment where you can do your best work, continue growing, and feel confident in the role you play within a team.

When you join Level Up Talent Solutions , you are not just filling a position. You are becoming part of a community that values clear communication, consistency, and mutual respect. We work closely with you to understand your strengths, your experience, and the type of work environment where you can thrive.

We support our talents through structured onboarding, ongoing guidance, and realistic expectations. You will always know what success looks like and who to turn to when you need support. We believe that when talents feel aligned and empowered, everyone succeeds.

At Level Up Talent Solutions, growth is not only about skills. It is about confidence, stability, and building a career you can be proud of.

We are here to help you level up.

Job Description

Work Set-up/Location: Temporary WFH; with onsite reporting as needed at the nearest Shearwater site in any of the following locations: Cebu, Manila, Pampanga, or Davao

Required License/Credentials: Active USRN license, any mainland U.S. state

Account Type: Non-Voice

Job Overview

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

This role is responsible for supporting nurse auditing, utilization review, bill review, and related clinical review processes. The position requires the ability to assess healthcare information carefully, follow account-specific guidelines, and maintain quality and compliance standards.

The ideal candidate is an active USRN with recent surgical hospital experience or clinical case management experience, plus hands-on exposure to nurse auditing, utilization review, and bill review.

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
  

Requirements

• Active USRN license from any mainland U.S. state
  
• At least 2 years of recent surgical experience in a hospital setting, or at least 2 years of clinical case management experience
  
• Experience with complex medical, legal, or consultation review is preferred
  
• At least 2 years of experience in the daily application of 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
  
• Able to meet quality and productivity standards in a healthcare operations environment
  

Nice to Have

• Surgical, utilization review, nurse audit, or bill review experience in a healthcare operations setting
  
• Experience reviewing complex medical, legal, or consultation-related cases
  
• Background supporting U.S. healthcare accounts or clinical process outsourcing