Job Title: QA Lead | USRN

Account: QA

Salary: Open Salary

Work location/Set up: TP Alphaland

Shift Schedule: GY

Key Responsibilities :

•Review and verify medical reports for accuracy

•Maintain and update documentation systems

•Handled communications with stakeholders

•Monitor compliance with healthcare regulations

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Non-Negotiable Requirements:
•Active and unrestricted U.S. Registered Nurse (USRN) license.

• Minimum 2 years of clinical bedside experience (ER, ICU, Med-Surg, Telemetry preferred).

• Minimum 1 year of USRN BPO or U.S. Healthcare experience in UM, CM, Appeals, Triage, or related clinical processes.

• Knowledge of MCG/Milliman, InterQual, clinical guidelines, HIPAA requirements, and U.S. medical terminology.

• Prior experience as a Quality Analyst, Clinical Auditor, or Clinical Reviewer in a U.S. healthcare account.

• Strong analytical skills with high attention to detail and documentation accuracy.

• Excellent written and verbal communication skills.


Preferred

• Familiarity with coding systems (ICD-10, CPT) is a plus.

• Strong proficiency in MS Office tools and QA evaluation systems.