USRN Authorization Reviewer | 1–3 Years Acute Care Exp + 1+ Year Healthcare BPO

apartmentEpsilon Group Services placeQuezon City scheduleFull-time calendar_month6/20/26

USRN Clinical Authorization Reviewer | Onsite | 1–3 Years ICU, ER, or Med-Surg Experience Required | 1+ Year Prior Authorization/UR BPO Experience

Location: Quezon City / Taguig
Work Setup: Onsite

Employment Type: Full-Time

Job Summary

We are hiring experienced USRN professionals with a strong background in acute hospital care and healthcare BPO operations to join our team as Clinical Authorization Reviewers.

The role involves reviewing medical records, evaluating medical necessity, and supporting authorization decisions using established clinical guidelines and criteria.

Qualifications (Strict Requirements)

Bachelor of Science in Nursing
Active PHRN License
Active USRN License (at least one active US State License)
1–3 years acute hospital experience in any of the following:
Medical-Surgical (Med-Surg)
Intensive Care Unit (ICU)
Emergency Department (ER)
Minimum of 1 year healthcare BPO experience in:
Prior Authorization
Utilization Review (UR)
Experience using InterQual and/or MCG guidelines
Strong clinical review and documentation skills
Excellent communication and critical thinking skills
Willing to work onsite in Quezon City or Taguig

Not Qualified If

No active USRN license
No acute hospital experience
No Prior Authorization or Utilization Review experience
No healthcare BPO experience
No InterQual or MCG experience
Not willing to work onsite

What We Offer

Competitive salary package
HMO and company benefits
Career growth opportunities
Stable healthcare account
Supportive work environment

starFeatured

Healthcare director – must have solid healthcare bpo operations experience

apartmentEpsilon Group ServicesplaceQuezon City

HEALTHCARE DIRECTOR – MUST HAVE SOLID HEALTHCARE BPO OPERATIONS EXPERIENCE | PHP 200K–250K Location: Pasig City (Onsite) Shift: Night Shift Start Date: ASAP We are looking for an experienced Healthcare Director to join a leading healthcare BPO...

business_centerHigh salary

Customer Service Representative - BPO Travel Account | 1-Day Process!

apartmentArbitrailplaceQuezon City

Arbitrail is expanding! We are hiring Customer Service Representatives to join our growing BPO team. Location: Ortigas, Pasig City Schedule: Must be amenable to work on a shifting schedule Qualifications: • With at least 6 months BPO experience...

thumb_up_altRecommended

Customer Service Agent (No BPO Experience) | College/SHS Grads are welcome!

apartmentFoundeverplaceQuezon City

for? • With or Without BPO Experience • Completed at least Senior High School or two (2) years of college education • Basic computer navigation skills • Good to Excellent Communication skills & Comprehension What should you expect from us? • Paid training from day...