USRN Quality Assurance Specialist
Gratitude IncUSRN Quality Assurance Specialist
Job Description
Key Skills
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Job Title: USRN Quality Assurance Specialist
Shift: Night shift
Work Set-up: On-site in Bridgetowne, Quezon City
Salary range: 60K to 90K
Start date: Dec 31, 2025/ ASAP
QUALIFICATIONS:
• Bachelor's Degree in Nursing with an active and valid license in USRN Massachusetts
• Minimum of 1 year experience in appeals and grievances workstream with focus on Medicare Part C Appeals
•At least 1 year to 2 years experience as a Quality Assurance or Quality Evaluator in a clinical BPO or CPO setting
• In-depth knowledge and understanding of CMS Medicare Part C Appeals regulatory standards
• Strong understanding of clinical terminology, medical necessity review principles and healthcare insurance operations
• Experience supporting external audits (CMS Program Audits) and Client Audits
• Must have an experience in mentoring or coaching new quality staff
• Excellent verbal and written communication skills
• High attention to detail with strong documentation, writing, and scoring calibration skills
• Proficiency in Quality Audit Systems and Microsoft Office Suite
• Strong analytical, critical thinking and problem solving skills
• Excellent communication, coaching, and collaboration abilities
• InterQual experience of at least 1 year (Medicare and Medicaid)
• Willingness to work on-site with flexible schedules, including US hours and holidays
Role
Account Manager
Timings
Night Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Process
Voice
Functional Area
ITES / BPO / Customer Service
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
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