Nurse - PHRN - Medical Billing

6 days ago

Pasig, National Capital Region, Philippines TASQ Staffing Solutions Full time

About the job: PHRN - Medical Billing (100% Onsite in Ortigas) | To Start on January 29, 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 29, 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
  • PHRN with BPO experience at least 1 year in prior authorization or 1 year eligibility, claims and benefits (payer)
  • Good English communication skills
  • Knowledge of healthcare regulations and compliance
  • Ability to work independently and as part of a team

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