job description
WNS is a global leader in Business Process Management, and we are currently expanding our clinical team in Bali. We are looking for highly skilled US Registered Nurses (USRN) who are passionate about healthcare excellence and clinical integrity. This is a unique opportunity to represent a prestigious global company and its international clients with dignity and compassion. We offer a high-performance environment where your clinical expertise is valued and rewarded.
As a USRN Specialist, you will be at the forefront of clinical decision-making, ensuring that patient care aligns with established medical guidelines and regulatory standards. Our commitment to our employees is reflected in our industry-leading compensation packages, including a recurring bonus of up to 100K for successful candidates. Whether you are looking to transition from bedside care to a corporate clinical role or seeking a new challenge in utilization management, WNS provides the platform for a stable and rewarding career.
We pride ourselves on a culture of inclusivity and professional growth. By joining our Bali operations, you will work with a diverse team of healthcare professionals dedicated to improving patient outcomes through meticulous clinical review and case management. Our process-driven approach ensures that you have the tools and support needed to succeed while maintaining the highest ethical standards in the healthcare industry.
Responsibility
- Conduct clinical reviews of medical records to determine the medical necessity of requested services.
- Ensure all clinical documentation is compliant with US healthcare regulations and HIPAA standards.
- Collaborate with US-based healthcare providers and insurance payers to facilitate efficient case management.
- Apply clinical expertise to utilization management and prior authorization processes across various specialties.
- Maintain accurate and detailed electronic health records in accordance with client-specific guidelines.
- Participate in quality audit sessions to improve process efficiency and clinical accuracy.
- Provide compassionate and professional representation of the company in all clinical communications.
Qualifications
- Must possess an active and unrestricted US Registered Nurse (USRN) license.
- Minimum of 2 years of clinical experience in a hospital setting or healthcare BPO environment.
- Bachelor of Science in Nursing (BSN) degree from an accredited institution.
- Excellent verbal and written English communication skills for client-facing interactions.
- Strong analytical skills with the ability to interpret complex medical data and guidelines.
- Proficiency in using clinical decision support tools and electronic medical record (EMR) systems.
- Willingness to work on a shifting schedule to align with US time zones.