US Registered Nurse (South Carolina Account)

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

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

Qualifications

• 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

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