Licensed Nurse

6 days ago

Pasig, Philippines TASQ Staffing Solutions Full time

About the job: PHRN - Medical Billing (100% Onsite in Ortigas) | To Start on January 29, 2026 WITH SIGNING BONUS * Work setup: 100% Onsite (Ortigas, Pasig City) Shift: Shifting schedule—predominantly night shift Start Date: January 29, 2026 Responsibilities: Coverage and Access Specialist (PHRN) Professionally and compliantly interact with insurance payer representatives during outbound phone calls for benefit verifications (New BVs, Annual reverification BVs and Bridge Eligibility Checks) and coverage exception follow-up calls (Prior Authorization (Pas), Non-Formulary Exceptions (NFEs) and Appeals)The volume and case type to be worked to be determined by Novartis, but in collaboration with supplier based on current SLAs within the PSC and expected agent productivityAccurately and concisely document payer interactions to inform cross-functional partners on the patient's coverage status Care Navigator (PHRN) Develop and maintain Subject Matter Expert (SME) level knowledge of the relevant brand and customer workstreams for the specific assigned programLearn and utilize protocols to respond to customer phone, chat, fax, SMS/text, mail, and e-mail inquiries, as well as other communication channels in a prompt and courteous mannerProfessionally and compliantly interact with customers, relevant Novartis associates, and other external contacts during inbound and outbound phone callsManage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required Requirements: Must have an active PHRN licensePHRN with BPO experience at least 1 year in prior authorization or 1 year eligibility, claims and benefits (payer)Good English communication skillsKnowledge of healthcare regulations and complianceAbility to work independently and as part of a team

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