PHRN Clinical Review Team Lead | Hybrid

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced PHRN Team Lead to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account specific roles and responsibilities:

Team Lead

• Oversees daily operations for all agents delivering high-quality and valued services
• Conduct training and coaching, including insights and action plans to improve
• Analyze and report on productivity and other metrics - such as attendance, end-of-day reports, and compliance with company protocols
• Ensure that the client is updated on significant program activities, issues, and concerns through calls, emails, meetings, reports
• Perform other supervisory tasks as required

Clinical Review

• Review and audit patient charts and clinical documentation.
• Verify that ICD-10 diagnosis codes appropriately correspond with documented treatments and services.
• Evaluate patient care plans to ensure alignment with diagnoses, prescribed treatments, and documented services.
• Complete structured audit reports consisting of 140+ audit questions for each patient chart.
• Ensure chart reviews are conducted with a high level of accuracy, consistency, and adherence to documentation standards.
• Maintain productivity targets by completing patient chart audits within an average timeframe of approximately 30 minutes per chart.
• Identify discrepancies, inconsistencies, or documentation gaps and flag them appropriately through the reporting process.
• Follow established workflows, auditing procedures, and quality standards for chart review activities.

• Must have an active Philippine Registered Nurse (PHRN) license.
• With 2+ years clinical nursing experience
• At least 1 year of team lead / supervisory experience
• Familiarity with ICD-10 diagnosis codes.
• Strong knowledge of insurance verification, prior authorizations, and EMR systems (KanTime).
• Experience reviewing or matching clinical documentation, treatments, and care plans
• High level of attention to detail and analytical skills.
• Proficient in Microsoft tools and web-based forms.
• Good verbal and written English skills
• Must be able to report onsite in Shaw Blvd, Mandaluyong
• Amenable working night shifts

What can we offer you?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid time off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our commitment to you

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all inclusive environment where everyone thrives