Clinical Account Specialist - Nursing Graduates

Location: Philippines REMOTE (WFH) | FULL-TIME | 9PM-6AM PHT (FIXED SCHEDULE) Neolytix is specifically looking for people who've already done hybrid clinical-operations work and been both things at once: have completed a nursing degree, and who also knows how to work on queues, productivity targets, multiple systems, and service-level expectations. WHAT YOU WILL DO: Review clinical documentation and chart notes for completeness, medical necessity, and accuracy in support of authorization, utilization review, or documentation workflows. Apply clinical judgment to prior authorization, precertification, or utilization review requests, working within established clinical and payer review criteria. Navigate structured, high-volume queues and multiple systems — EHR/EMR, payer portals, and case management or workflow tools — while meeting daily productivity and turnaround expectations. Document findings, decisions, and communications completely and accurately, keeping records audit-ready. Coordinate with physicians, nurses, and other clinical staff on cases that need additional information or a peer-to-peer review. Escalate complex or time-sensitive cases appropriately and track them through to resolution. Maintain compliance with HIPAA, payer requirements, and internal quality standards. Required: A completed nursing degree, combined with healthcare BPO experience. WHY APPLY? This role allows you to do work that actually uses your clinical training! If you've done clinical work inside a structured, queue-driven operations environment before, you got what we need!