PHRN - AR Executive (Prior Authorization) SOB 40K | ONSITE

2 days ago

Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $40,000 - $80,000 per year

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 business process outsourcing preferably
  • 1–2 years of experience of US healthcare authorization business

We are accepting walk in candidates from 9AM - 5PM weekdays.

  • Prior-Authorization Nurses USRN

    2 days ago

    Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corporation Full time $40,000 - $60,000 per year

    WE'RE HIRING – Prior-Authorization Nurse (PHRN/USRN) – Pioneer Account Location: Ortigas (Onsite) Company: VISAYABe part of a pioneer team supporting patient care through prior-authorization and utilization review services. Qualifications:Graduate of BS Nursing with an active PHRN or USRN licenseAt least 3–5 years of solid experience in:Utilization...

  • AR Executive

    2 days ago

    Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $40,000 - $80,000 per year

    Work with the No. 1 Healthcare BPOAn Accounts Receivable (AR) Executive with a PH Registered Nurse (PHRN) license and hospital experience typically works in healthcare-related financial operations, often within business process outsourcing (BPO) or medical billing roles. Here's a general job description:Job ResponsibilitiesPrior Authorization Processing:...

  • PHRN - Prior Authorization / Hospital Experience – up to 50K salary package

    2 days ago

    Pasig, National Capital Region, Philippines Cobden & Carter International Full time $40,000 - $50,000 per year

    Qualifications:Must have an active PHRN licenseWith at least 1 year experience in Healthcare BPO – prior authorization experience is preferred but not required and/or at least 1-2 years bedside care experience in an acute setting (clinics are not included)Good communication skillsMust be amenable to work ONSITE (Site Location: Ortigas, Pasig)Duties and...

  • PHRN - QA (Prior Authorization) ONSITE

    2 days ago

    Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $40,000 - $80,000 per year

    Job Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgencyReview patient's clinical and chart documentation related to the service submitted by the provider's officeObtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...

  • PHRN - TL (Prior Authorization) ONSITE

    2 days ago

    Pasig, National Capital Region, Philippines Omega Healthcare Management Services Inc. Full time $80,000 - $120,000 per year

    Job Duties and ResponsibilitiesPrioritize incoming authorization and referral requests according to queue urgencyReview patient's clinical and chart documentation related to the service submitted by the provider's officeObtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods—depending...

  • Prior Authorization Specialist

    2 days ago

    Pasig, National Capital Region, Philippines Connext Global Solutions Inc Full time $40,000 - $60,000 per year

    Connext is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.We are currently looking for a Prior Authorization Specialist who will be working with Connext's Client in the United...

  • Registered Nurse

    2 days ago

    Pasig, National Capital Region, Philippines Nezda Technologies, Inc. Full time ₱900,000 - ₱1,200,000 per year

    Job Title:PHRN – Healthcare Account (Voice Campaign)Job Description:We are looking for a Philippine Registered Nurse (PHRN) to join our Healthcare Voice Campaign team. The role involves providing professional support to patients and healthcare providers, ensuring accurate information and excellent service delivery.Qualifications:Must be a Philippine...

  • Virtual Process| Up to 28k + 30k SOB Healthcare CSR Hiring

    2 days ago

    Pasig, National Capital Region, Philippines Nezda Technologies, Inc. Full time ₱58,000 per year

    About the role We are seeking a motivated Healthcare Customer Service Representative to join our dynamic team based in Pasig City Metro Manila, this full-time role will provide you with the opportunity to deliver exceptional customer service and support to our valued clients.What you'll be doingHandling inbound customer inquiries and requests via phone,...

  • AR Specialist

    2 days ago

    Pasig, National Capital Region, Philippines GUS Education PH Full time ₱800,000 - ₱1,200,000 per year

    Job Responsibilities:Book student invoices in the accounting system Compute and book the monthly recognition of deferred revenue and revenue in the accounting system Allocate and clear out of student payments and ensuring that customer accounts are reconciled Collaborate with the credit control department for student-related concerns Prepare the updated...

  • ar collections specialist

    2 days ago

    Pasig, National Capital Region, Philippines Outsource Accelerator Full time ₱1,500,000 - ₱2,000,000 per year

    Outsource Accelerator is the trusted source for independent information, advisory and expert implementation of Business Process Outsourcing (BPO). We are the #1 Outsourcing Authority, and we offer the worlds leading aggregator marketplace for outsourcing. We specifically provide the conduit between Philippines outsourcing suppliers and the businesses clients...