Nurse
6 days ago
About the job: PHRN - Medical Billing (100% Onsite in Ortigas) | To Start on January 19, 2026
WITH SIGNING BONUS *
*-depending on experience, to be discussed at the latter part of the process
Work setup: 100% Onsite (Ortigas, Pasig City)
Shift: Shifting schedule, predominantly night shift
Start Date: January 19, 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 productivity
- Accurately 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 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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