Healthcare Specialist (USRN)

TL;DR

Healthcare Specialist (Clinical Review): Performing clinical review of medical cases and adjudication with an accent on clinical intake and records analysis. Focus on coordinating with facility personnel to acquire missing information and escalating complex cases to Medical Directors.

Location: Bridgetowne Boulevard, Quezon City, Philippines

Company

hirify.global is an Agentic AI-powered leader in intelligent operations and transformation serving over 700 clients across multiple global industries.

What you will do

• Conduct clinical reviews for cases not meeting standard criteria.
• Perform clinical intake and adjudicate or close medical cases.
• Collaborate with facility personnel and providers to request additional clinical information.
• Escalate high-complexity cases to Medical Directors.

Requirements

• Active PRC and USRN License.
• Minimum 2 years of experience in hospital and medical records.
• Excellent verbal and written communication skills.
• Strong knowledge of the healthcare and medical domain.
• Willingness to work on shifting schedules, including night and graveyard shifts.
• Availability to work on holidays and weekends.

Culture & Benefits

• Structured career path with internal progression opportunities.
• Free HMO coverage from day 1, including domestic partners.
• Professional skills training opportunities.
• Paid leaves and annual performance appraisals.
• Safe and supportive work environment.