Licensed Nurse
3 hours ago
About the job PHRN - Medical Billing (100% Onsite in Ortigas)
WITH SIGNING BONUS*
Start dates:
December 15, 2025 (with options for January 12 or 19, 2026)
Work setup: 100% Onsite (Ortigas, Pasig City)
Shift: Shifting schedule - predominantly Nightshift
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)
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 productivity
Accurately and concisely document payer interactions to inform cross-functional partners on the patients 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 program
Learn 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 manner
Professionally and compliantly interact with customers, relevant Novartis associates, and other external contacts during inbound and outbound phone calls
Manage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required
Requirements:
Must have an active PHRN license
With or without BPO experience
Good English communication skills
Knowledge of healthcare regulations and compliance
Ability to work independently and as part of a team
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