Dr. Amando L. Garcia Medical Center, Inc jobs

RN Clinical Case Reviewer and Verification Clinical Intake Specialist

Location: Remote — Philippines Only

Employment Type: Full‑Time Contractor

Schedule: Night Shift 8 PM – 10 AM PH Time | U.S. Business Hours | Weekend Rotation Possible

Payment: Biweekly via Wise

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Role Summary

We are hiring Philippines‑based Registered Nurses for a combined role that performs clinical case review, case verification, and clinical intake for a U.S.‑based healthcare and legal operations team. This fully remote, non‑bedside position requires clinical judgment, medical record interpretation, structured claimant interviewing, and meticulous documentation to produce attorney‑ready case files.

Important: This role may involve exposure to sensitive case content, including child abuse, sexual abuse, and other trauma. Candidates must be professionally comfortable handling such material.

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Why Communication and Call Work Matter

This is a phone‑centric role. Beyond medical record review, calling and direct communication with claimants is essential. You will both initiate and receive calls to collect clinical histories, clarify records, and build trust with clients. Candidates must be willing and able to:

• Conduct frequent outbound and inbound calls with U.S.‑based claimants.
• Comfortably manage sensitive conversations with empathy, professionalism, and trauma‑informed communication.
• Handle difficult or emotional interactions calmly and de‑escalate when needed.
• Respond to urgent call‑back requests or time‑sensitive follow‑ups as required by case needs.
• Document call content accurately and convert verbal information into clear, attorney‑ready notes.
• Work to build rapport while maintaining clinical objectivity and confidentiality.

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Key Responsibilities

• Conduct structured claimant interviews by phone to collect clinical history and event timelines.
• Perform comprehensive medical record review including progress notes, imaging, operative reports, and ancillary documentation.
• Validate medical histories, injuries, and treatments against records and claimant statements.
• Synthesize clinical timelines and prepare concise, structured clinical summaries suitable for legal review.
• Identify inconsistencies, red flags, or indicators of non‑legitimate claims and escalate per protocol.
• Document findings clearly and accurately in internal case management systems; maintain version control.
• Support evidence collection and case file development by requesting targeted records and clarifying gaps.
• Provide clinical input on case triage, severity, and evidentiary needs to U.S. clinical leads.
• Adhere to HIPAA and data privacy standards at all times.

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Required Qualifications

• Bachelor’s degree in Nursing and active Philippine RN license (PRC).
• Based in the Philippines and available to work U.S. day shift hours (night shift PH).
• Strong spoken and written English.
• Experience communicating with patients by phone (clinical, telehealth, or BPO).
• Minimum 1 year experience in medical record review, case management, utilization review, or a clinical role involving documentation review.
• Excellent clinical assessment and documentation skills; ability to interpret diagnostic tests and treatment plans.
• Comfort working with sensitive and potentially traumatic case content.
• Willingness to take frequent inbound/outbound calls and occasional urgent call‑backs.
• Proficiency with Microsoft Office 365 and Adobe Acrobat DC.

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Preferred Qualifications

• U.S. RN license (NCLEX passer) preferred.
• Experience in healthcare BPO, telehealth, medico‑legal review, or clinical documentation improvement.
• Familiarity with U.S. healthcare terminology and payer systems.
• Prior experience preparing clinical summaries for legal or insurance audiences.
• Experience managing high call volumes and meeting productivity targets.

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Equipment Requirements Contractor Provided

• Computer with Intel i5 or equivalent processor, minimum 8GB RAM, dual‑monitor setup.
• Stable internet connection, minimum 20 Mbps.
• Quality headset.

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Compensation and Schedule

• Training (paid): PHP 32,500/month.
• Post‑Training: PHP 37,500/month (net) + productivity bonuses.
• Candidates with extensive medical record review or advanced clinical reviewer experience may be eligible for higher starting compensation; final offer will reflect experience and role scope.
• Hours: 8‑hour shifts, 40 hours/week | shifts vary between 8 PM–10 AM PH Time. Weekend rotation possible.

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Application Instructions

Submit your resume and cover letter indicating you are applying for the Combined RN Clinical Case Reviewer & Verification/Intake role. Include brief examples of prior medical record review or clinical summary work if available.

Application Question(s):

• Are you available to work night shifts?
• Are you willing to take frequent inbound and outbound calls and occasional urgent call‑backs?
• Do you have experience reviewing medical records or preparing clinical summaries? If yes, briefly describe.

Job Type: Full‑time contractor

Education: Bachelor’s in Nursing (Required)

Experience: Medical records reviewer: 1 year (Preferred)

Language: English (Required)

License/Certification: Nursing license (Required)

Work Location: Remote — Philippines Only

Pay: Php32,500.00 - Php37,500.00 per month

Benefits:

• Opportunities for promotion
• Work from home

Application Question(s):

• Are you willing to work night shifts? (Yes/No)
• Are you willing to take frequent inbound and outbound calls and occasional urgent call‑backs? (Yes/No)
• Do you have experience reviewing medical records or preparing clinical summaries? (Yes/No) If yes, briefly describe.
• Do you have a dual monitor setup? (Yes/No)

Education:

• Bachelor's (Required)

Experience:

• Customer service: 1 year (Required)

Language:

• English (Required)

License/Certification:

• PHRN License (Required)

Work Location: Remote