Clinical Records Analyst (Cebu Onsite)

Review incoming medical records for completeness, relevance, and quality based on claim requirements Develop a clinical chronology by organizing records to reflect the progression of diagnosis and treatment Identify and differentiate diagnostic records from severity-related documentation Assess medical records for causation support and relevance to the claimed condition Detect gaps in clinical evidence (e.

g., missing records, insufficient documentation, inconsistencies) and escalate with proper rationale Utilize OCR tools (e.g., Adobe Acrobat) to process scanned documents; flag illegible records for reprocessing Evaluate physician-issued severity letters to ensure alignment with required clinical standards Maintain accurate filing and documentation of records within internal systems Update system fields and ensure all relevant information is properly recorded Manage daily task queues and prioritize urgent or time-sensitive cases Communicate with medical providers or facilities when additional documentation is required Requirements Okay to work the night shift/Graveyard schedule Willing to work on-site Licensed Nurse (RN) or equivalent clinical professional (Philippine license accepted; active license preferred) at least 6 months BPO experience (healthcare account experience is an advantage) Strong ability to read, interpret, and analyze medical records at a clinical level Experience in medical documentation, clinical review, or medicolegal records is preferred Excellent written communication skills with the ability to present clinical findings clearly and concisely Good verbal communication skills and willingness to coordinate with medical providers when needed