Clinical Records Analyst (Cebu Onsite)

Job Description

• 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