PHRN Quality Auditor
7 hours ago
Position Title: PHRN Quality Auditor - Prior/Clinical Authorization
Location: McKinley, Taguig
Work Set-up: Full Onsite | Night Shift
Direct Hire | Permanent role
Qualifications:
- Must hold an active PHRN license
- With relevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment
- Open for Associate/CSR with 4+ years of specialized experience in Clinical Authorization, Prior Authorization or Utilization Review is required (with PHRN active license).
- Demonstrated job stability, with a consistent employment history and minimal transitions
Brief Job Description:
- Completing QA audits
- Participating in client calls to capture process updates and monitoring compliance.
- Contact insurance carriers to verify patient's insurance eligibility, benefits, and requirements
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