Phrn With Bpo Healthcare Experience

1 day ago

Metro Manila Philippines Buscojobs Full time

Overview

Job Duties and Responsibilities

  • Prioritize incoming authorization and referral requests according to queue urgency
  • Review patient's clinical and chart documentation related to the service submitted by the provider's office
  • Obtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending on the payer's policy:
    • Perform outbound calls to payer's authorization department
    • Access payer's authorization online portal
    • Submit faxes to payer's authorization department
    • Respond to payer's clinical questions to be able to proceed with the authorization and referral requests
    • Obtain and/or follow up payer's peer-to-peer review requirements and send them back to provider's office for the actual initiation
    • Cater inbound calls from payers and perform necessary actions required for the task
    • Listen and review voicemail messages from payers then perform necessary actions required for the task
Required Skills
  • Solid understanding of anatomy & physiology, including how body systems function and an understanding of disease processes
  • Comprehensive understanding of Medical Terminology
  • Prior experience in processing multispecialty authorizations including contact with payers
  • 2 years experience of acute hospital experience
  • Experience in prior authorization process
  • Experience with general computer software (Internet, Word, Outlook, PDF required)
  • Proficiency to learn new software programs quickly
  • Excellent customer service skills: communicates clearly and effectively
  • Excellent verbal and written communication skills
  • Professional and effective interaction skills with co-workers, clients, providers, and vendors
  • Proven ability to work well individually and as a team member
  • Strong attention to detail
  • Ability to follow company and account-specific standard operating procedures and policies
  • Ability to adapt to constantly changing environment
  • Ability to prioritize and organize multiple tasks by remaining focused and quality-driven at all tasks at hand
  • Ability to remain organized with multiple interruptions
  • Ability to make decisions independently without bypassing any company and account-specific standard operating procedures and policies
  • Ability to comfortably receive constructive feedback
Required Experience
  • Graduate of Bachelor of Science in Nursing with active PH registered nurse license
  • 1–2 years of experience in healthcare business process outsourcing
  • 1-2 years of hospital/clinical experience
  • Walk-in candidates accepted 11AM-5PM weekdays
#J-18808-Ljbffr

  • PHRN Team Leader – Healthcare BPO

    4 days ago

    Manila, National Capital Region, Philippines Global Group Innovative Services, Inc. Full time ₱600,000 - ₱744,000 per year

    PHRN Team Leader – Healthcare BPO | Up to PHP 62K | Quezon City (Onsite) Salary Range: PHP 50,000 – 62,000 (depending on experience) Work Setup: Onsite – Bridgetowne, Quezon CityJob SummaryTake your nursing career to the next level We're hiring a licensed PHRN with leadership experience in Healthcare BPO to lead a team in Prior Authorization...

  • Operations Manager

    1 day ago

    , Metro Manila, Philippines HRTX Full time

    Operations Manager / Team Leader (Healthcare Account – BPO) Job Openings Operations Manager / Team Leader (Healthcare Account – BPO) About the job We are looking for a licensed Philippine Registered Nurse (PHRN) with strong BPO leadership experience to manage operations and lead teams for a Healthcare account. This role combines operational oversight...

  • PHRN with Prior Authorization Review Experience in BPO 50k

    2 weeks ago

    manila, Philippines GGAS Services Full time

    PHRN with Prior Authorization Review Experience in BPO Salary: 45k–50k (depending on last pay) Location: On-site in Ortigas, Manila Can start ASAP Can work night shift Must have at least 1 year prior authorization review experience in BPO Must have bedside experience Must have valid PHRN

  • PHRN with Prior Authorization Review Experience in BPO 50k

    5 days ago

    Manila, Philippines GGAS Services Full time

    PHRN with Prior Authorization Review Experience in BPO Salary: 45k–50k (depending on last pay) Location: On-site in Ortigas, Manila Can start ASAP Can work night shift Must have at least 1 year prior authorization review experience in BPO Must have bedside experience Must have valid PHRN

  • phrn

    4 days ago

    Manila, National Capital Region, Philippines GGIS - Global Group Innovative Services Full time ₱45,000 - ₱55,000 per year

    PHRN - Healthcare CSRValid PRC LicenseCan work onsite - nightshift (Ortigas)1 year prior authorization BPO experience1 year Hospital experiencePhp45,000-55,000Job Type: Full-timePay: Php45, Php50,000.00 per monthBenefits:On-site parkingPaid trainingWork Location: In person

  • PHRN Quality Analyst

    4 days ago

    Manila, National Capital Region, Philippines Gap Solution Recurrent Firm Full time ₱50,000 - ₱55,000 per year

    PHRN Quality Analyst (QA)Location: Ortigas (Onsite)Shift: Night ShiftSalary: PHP 50,000–55,000 | Can Start ASAPQualifications:Must be a Registered Nurse (PHRN) with a valid PRC license1–2 years of experience as a Quality Analyst (QA) in the BPO/Healthcare industryStrong background in quality monitoring and compliance in healthcare accountsWilling to work...

  • PHRN Healthcare Team Leaders NEEDED 60K

    2 days ago

    Manila, National Capital Region, Philippines Global Group Innovative Services, Inc. Full time ₱600,000 - ₱624,000 per year

    5 PHRN Healthcare Team Leaders and 2 PHRN Healthcare Quality Analysts5 PHRN Healthcare Team Leaders2 years Hospital Experience1 year of PHRN Healthcare Team Leader ExperienceCan work onsiteCan start asap3 Easy steps before your Job Offer60, ,000php + night diff2 PHRN Healthcare Quality Analysts1 year PHRN Healthcare QA experience is a mustwilling to work...

  • USRN-Senior Operations Manager

    2 weeks ago

    manila, Philippines Gap Solution Recurrent Firm Full time

    Senior Operations Manager – USRN (BPO Healthcare Account) Location: NCR, Philippines (Onsite) Account: UMR Healthcare Compensation: Salary will be based on your most recent paycheck Qualifications: • 3 to 5 years of experience as a Senior Operations Manager in a BPO Healthcare account • Valid PHRN and USRN licenses • Strong leadership background...

  • USRN-Senior Operations Manager

    5 days ago

    Manila, Philippines Gap Solution Recurrent Firm Full time

    Senior Operations Manager – USRN (BPO Healthcare Account) Location: NCR, Philippines (Onsite) Account: UMR Healthcare Compensation: Salary will be based on your most recent paycheck Qualifications: • 3 to 5 years of experience as a Senior Operations Manager in a BPO Healthcare account • Valid PHRN and USRN licenses • Strong leadership background...

  • PHRN Quality Analyst

    5 days ago

    Manila, Philippines Gap Solution Recurrent Firm Full time

    PHRN Quality Analyst (QA) Location: Ortigas (Onsite) Shift: Night Shift Salary: PHP 50,000–55,000 | Can Start ASAP Qualifications: Must be a Registered Nurse (PHRN) with a valid PRC license 1–2 years of experience as a Quality Analyst (QA) in the BPO/Healthcare industry Strong background in quality monitoring and compliance in healthcare...