PHRN Quality Analyst ( RCM ) or Prior Auth 57K - 58K

PHRN Quality Analyst – Prior Authorization / Healthcare

Salary Package: PHP 55,000 – PHP 57,000 + 10% Night Differential

Job Summary

We are seeking experienced PHRN Quality Analysts with a solid background in Prior Authorization within a US Healthcare BPO environment. The successful candidate will be responsible for monitoring quality performance, conducting audits, ensuring compliance with client standards, and supporting continuous quality improvement initiatives.

• Active Philippine Registered Nurse (PHRN) license
• At least 1 year of PHRN Healthcare Quality Analyst experience in a US Healthcare BPO environment (required)
• Solid Prior Authorization experience
• Strong knowledge of healthcare quality standards and auditing processes
• Excellent analytical, coaching, and communication skills
• Ability to identify quality gaps and recommend process improvements
• Willing to work onsite in Ortigas Center
• Amenable to permanent night shift
• Can start as soon as possible

• Conduct quality audits for Prior Authorization transactions
• Evaluate compliance with client, regulatory, and internal quality standards
• Identify performance gaps and provide actionable feedback
• Maintain quality documentation, reports, and audit scorecards
• Participate in calibration sessions and continuous improvement initiatives
• Work closely with Operations and Training teams to improve quality performance and customer outcomes

PHRN Quality Analyst – Hospital Billing / Revenue Cycle Management (RCM)

Salary Package: PHP 57,000 – PHP 58,000 + 10% Night Differential

Job Summary

We are looking for experienced PHRN Quality Analysts with a strong background in Hospital Billing, Revenue Cycle Management (RCM), or Prior Authorization within a US Healthcare BPO environment. The ideal candidate will be responsible for auditing transactions, ensuring compliance with quality standards, identifying process gaps, and driving continuous improvement to support operational excellence.

• Active Philippine Registered Nurse (PHRN) license
• At least 1–2 years of Quality Analyst (QA) or Auditing experience in a US Healthcare BPO environment
• Solid Healthcare RCM or Hospital Billing experience
• Strong experience auditing healthcare transactions and ensuring adherence to quality standards
• Experience auditing Hospital Billing processes is required
• Knowledge of Prior Authorization processes is an advantage
• Experience using the EPIC Platform is highly preferred
• Strong understanding of call quality standards, process compliance, and documentation guidelines
• Excellent analytical, coaching, and communication skills
• Willing to work onsite in Ortigas Center
• Amenable to permanent night shift
• Can start as soon as possible

• Perform quality audits on Hospital Billing, Revenue Cycle Management (RCM), and Prior Authorization transactions
• Evaluate employee performance against quality and compliance standards
• Ensure adherence to client policies, HIPAA regulations, and operational procedures
• Identify quality trends, process gaps, and improvement opportunities
• Provide constructive feedback and coaching to improve agent performance
• Prepare quality reports, scorecards, and audit findings
• Partner with Operations and Training teams to improve overall quality metrics
• Participate in calibration sessions and quality improvement initiatives

Email Subject:

PHRN QA Prior Auth

or

PHRN QA Hospital Billing

or

PHRN QA HC

Send your application to:

••••@epsilongroupservices.com

••••@outlook.com