[Hiring] Clinical Auditor @ISTA Personnel Solutions
Mar 25, 2025 - ISTA Personnel Solutions is hiring a remote Clinical Auditor. 💸 Salary: competitive salary and benefits. 📍Location: Philippines.
Role Description
ISTA Solutions is in search of an experienced Clinical Auditor to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance.
- Review and process authorization requests for long-term care services, ensuring compliance with policies, guidelines, and payer requirements.
- Review billing records for accuracy, including coding for services rendered, ensuring that all claims are properly submitted and follow-up is done for reimbursement.
- Communicate with insurance companies to clarify authorization requirements, resolve billing discrepancies, and ensure timely approvals for long-term care services.
- Audit clinical records and documentation to ensure they meet the standards for authorization and billing, identifying any gaps or discrepancies in documentation or services rendered.
- Work closely with healthcare teams, administrators, and other stakeholders to ensure appropriate documentation and care plans are in place for authorization approval and billing accuracy.
- Ensure that all authorizations, billing practices, and insurance communications comply with state and federal regulations, as well as industry standards.
Qualifications
- Current and valid PHRN license
- Good working knowledge with US Healthcare Insurance
- Strong knowledge of prehospital patient care protocols, standards, and regulatory requirements.
- Excellent attention to detail and analytical skills.
- Good verbal and written English skills
- Ability to work independently and collaboratively in a team-oriented environment.
- Commitment to continuous learning and professional development.
- Must be residing within GMA (Greater Manila Area)
- Willing to work on shifting schedule (weekdays and weekends)
Benefits
- Competitive salary and benefits
- Health Insurance with free dependents*
- 10%-night differential
- Attendance Bonus
- Paid time off
- Convertible to cash leave credits
- Performance Appraisal
- Work-life balance
- A focus on growing your career path with us
- We encourage you to follow your passions and learn new skills
Company Description
ISTA Solutions is home to rockstar professionals who aim to be engaged in defining and building an employee centric culture, focused on long term success, work-life balance, and life-long learnings.
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| 📍 | Be aware of the location restriction for this remote position: Philippines |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
|
Salary
💸
competitive salary and benefits
|
Remote
Location
Philippines
|
|
Job Type
full-time
|
Posted
Mar 25, 2025
|
| 📍 | Be aware of the location restriction for this remote position: Philippines |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
