Phrn

2 days ago

Taguig, National Capital Region, Philippines HRTX Full time ₱35,000 - ₱50,000 per year


We're Hiring: PHRN Quality Auditor Clinical Services

Location: Onsite, Mckinley, Taguig
Schedule: Night Shift | Monday to Friday
Hiring Target Date: Preferably by July 21, 2025
Salary Range: Up to 50k

Qualifications

Must hold an active PHRN license (Not a USRN holder)
Prior experience as a Quality Auditor in a healthcare BPO clinical setting
Alternatively, 4 to 7 years of specialized experience in Clinical Authorization or Utilization Review
Strong knowledge of EPIC, MCG, or InterQual guidelines
Must have a stable work history with minimal employment transitions

Key Responsibilities
I. Quality Auditing
  • Conduct audits in accordance with Quality Improvement Plans (QIP)
  • Provide actionable feedback to team members and track corrections
  • Escalate compliance concerns, trends, and anomalies to leadership
  • Stay updated through production work and active participation in process updates
  • Join client calls to ensure accurate capture of updates and compliance
II. Clinical Process Management
  • Verify patient insurance eligibility, benefits, and requirements with payers
  • Request, track, and secure pre-authorizations for medical services and procedures
  • Review and follow up on oncology chemotherapy drug authorizations
  • Ensure HIPAA compliance and maintain proper documentation in EHR
  • Handle medical necessity documentation and assist in denial appeals
  • Prioritize cases based on urgency and patient impact
  • Communicate with insurance companies, healthcare providers, and patients as needed
  • Address clinical inquiries based on payer medical policy guidelines

  • phrn

    1 week ago

    Taguig, National Capital Region, Philippines AUMTREND PH INC Full time ₱360,000 - ₱720,000 per year

    2-6 yrs Clinical ExpMust be willing to work onsiteCan start ASAPJob Type: Full-timePay: Php30, Php60,000.00 per monthApplication Question(s):What is your email add?License/Certification:PHRN (Preferred)Work Location: In person

  • Non-Voice PHRN

    6 hours ago

    Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time ₱300,000 - ₱500,000 per year

    TASQ is looking to fill an on-site position for a PHRN to work on-site for a non-voice account ASAP.The pre-screening interview will take place over the phone.PHRN (Manila)Responsibilities:Coordinate the execution and continued quality of the clients department processesPerform assigned duties including but not limited to telephonic on-line authorization of...

  • Team Lead PHRN

    5 hours ago

    Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time ₱1,500,000 - ₱3,000,000 per year

    About the job: Team Lead PHRN (McKinley West Taguig) | Hybrid Work Setup: Amenable to working on-site during training (2-3 months), Hybrid work arrangement after training Location: McKinley West, Taguig Shift: Night Shift Schedule: Weekends Off Nature of Work: Voice Requirements:Nursing DegreeShould have an active PHRN licenseMust have experience handling a...

  • Team Lead PHRN

    2 days ago

    Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time ₱900,000 - ₱1,200,000 per year

    About the job: Team Lead PHRN (McKinley West Taguig) | HybridWork Setup: Amenable to working on-site during training (2-3 months), Hybrid work arrangement after training Location: McKinley West, TaguigShift: Night ShiftSchedule: Weekends OffNature of Work: VoiceRequirements:Nursing DegreeShould have an active PHRN licenseMust have experience handling a team...

  • PHRN - Prior Authorization Nurse

    1 week ago

    Taguig, National Capital Region, Philippines AUMTREND PH INC Full time ₱780,000 per year

    Position SummaryThe Prior Authorization Nurse (PHRN) will support the review and submission of prior authorization requests for behavioral health treatments, medications, or services. The nurse will review clinical documentation to ensure accuracy and medical necessity, complete required payer forms, and work closely with administrative support staff to...

  • Team Lead PHRN

    2 days ago

    Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time ₱1,500,000 - ₱3,000,000 per year

    Work Setup: Amenable to work onsite during training (2-3 months), Hybrid work arrangement after training Location: McKinley West, Taguig Shift: Night Shift Schedule: Weekends Off Nature of Work: Voice Duties and ResponsibilitiesLead and mentor a team of PHRNs handling claims, eligibility, and healthcare inquiries.Monitor key performance metrics (CSAT, NPS,...

  • USRN PHRN Representative

    2 days ago

    Taguig, National Capital Region, Philippines HRTX Full time ₱900,000 - ₱1,200,000 per year

    This role is responsible for improving the quality, accuracy, and completeness of clinical documentation in the medical record. This role collaborates with physicians, coders, and other healthcare team members to ensure documentation reflects the true clinical picture, supports appropriate code assignment, and meets regulatory and quality reporting...

  • PHRN Quality Assurance

    2 days ago

    Taguig, National Capital Region, Philippines AUMTREND PH INC Full time ₱600,000 - ₱1,080,000 per year

    2-6 yrs Clinical ExpWith BPO experience as QAMust be willing to work onsite in BGCWith Diploma and TORCan start ASAPJob Type: Full-timePay: Php50, Php90,000.00 per monthApplication Question(s):What is your email add?License/Certification:PHRN (Preferred)Work Location: In person

  • Phrn

    2 days ago

    Taguig, National Capital Region, Philippines HRTX Full time ₱103,162 - ₱552,000 per year

    Quality Auditor hiring Clinical Authorization Process.Onsite, Night Shift, Mon-FridayQualificationsMust hold an active PHRN license (not a USRN license holder)Relevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment; alternatively, 4 to 7 years of specialized experience in Clinical Authorization or Utilization Review...

  • PHRN Specialist

    2 days ago

    Taguig, National Capital Region, Philippines Cognizant Full time

    Cognizant is a global organization serving clients across multiple industries with a deep set of offerings provided by our practice areas and supported by corporate and enabling functions. Employing roughly 270,000 talented associates worldwide, Cognizant is dedicated to anticipating and solving clients' toughest problems and enabling them to thrive in the...