phrn clinical authorization

OverviewJob title: PHRN – Clinical AuthorizationWork set up: Onsite Opportunity – MCK Taguig, Cyber Sigma BuildingWork schedule: Weekdays Night Shift schedule, Fixed Weekends OffSalary: 45K to 50K package if licensed PHRN, salary for approval if non-licensedResponsibilitiesContact insurance carriers to verify patient’s insurance eligibility, benefits...

AGS Health Philippines, Inc. is seeking a qualified Utilization Review professional in the Philippines to verify insurance eligibility, obtain pre-authorizations, and review high-cost oncology treatments.The role requires a PHRN license and prior experience in utilization review or clinical authorization, with strong HIPAA knowledge and meticulous...

About the job PHRN - Utilization Review / Clinical AuthorizationWe're Hiring: PHRN Quality Auditor Clinical ServicesLocation: Onsite, Mckinley, TaguigSchedule: Night Shift | Monday to FridayHiring Target Date: Preferably by July 21, 2025Salary Range: Up to 50kQualificationsMust hold an active PHRN license (Not a USRN holder)Prior experience as a Quality...

Qualifications PHRN license holder Prior experience in Utilization Review and/or Clinical Authorization Responsibilities Contact insurance carriers to verify patients' insurance eligibility, benefits, and requirements. Request, track, and obtain pre-authorizations from insurance carriers within the required timeframe for medical services. Review, request,...

We are seeking a detail-oriented and organized Prior Authorization Specialist to join our healthcare team. In this role, you will be responsible for obtaining prior authorizations for medical procedures, diagnostic tests, and medications from insurance providers. You will serve as a key liaison between healthcare providers, patients, and insurance...

Job Summary We are seeking a Clinical Operations Manager – PHRN to oversee and optimize clinical operations within a healthcare BPO environment. The role is responsible for managing clinical teams, ensuring quality and productivity, maintaining compliance with healthcare standards, and supporting clients through efficient and accurate healthcare...

A healthcare service provider is looking for an administrative and clinical support professional in Quezon City. The role involves managing electronic medical records, processing medication authorizations, and scheduling patient appointments. Ideal candidates should be graduates of related healthcare courses and possess strong communication and...

Overview Work set up: Onsite Opportunity MCK Taguig, Cyber Sigma Building Work schedule: Weekdays Night Shift schedule, Fixed Weekends Off Responsibilities Effectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the validity of such denials in a timely manner --Should conduct comprehensive...

Job SummaryWe are seeking a Clinical Operations Manager – PHRN to oversee and optimize clinical operations within a healthcare BPO environment. The role is responsible for managing clinical teams, ensuring quality and productivity, maintaining compliance with healthcare standards, and supporting clients through efficient and accurate healthcare...

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Shearwater CPO® - Home of Clinicians is hiring for a PH Registered Nurse role with an onsite incentive. The position coordinates department processes, handles telephonic authorizations, and liaises with providers to ensure service eligibility while supporting inbound/outbound patient calls.The ideal candidate will hold a BS Nursing degree with an active PRN...

On-site - Quezon City 1-3 Yrs Exp Bachelor Full-time Job Description Medical Reimbursement We are seeking a licensed Registered Nurse to join our Clinical Analyst team. The successful candidate will review patient medical records, conduct clinical assessments, maintain accurate healthcare documentation, and collaborate with multidisciplinary teams to...

Make a Difference Beyond the Bedside Are you a passionate Registered Nurse looking to leverage your clinical expertise in a rewarding, non-bedside role? Join Sutherland as a Clinical Review Nurse (PHRN) and play a critical role in helping individuals navigate disability claims through accurate clinical assessments and meaningful collaboration with healthcare...

DescriptionPosition OverviewWe are seeking a detail-oriented, high-performing Revenue Cycle & Authorizations Specialist to manage patient eligibility, obtain prior authorizations, and drive accounts receivable (AR) recovery.This role manages a core volume of approximately 200 claims per week, with a primary focus on navigating and resolving complex claim...

EPSILON GROUP SERVICES INC. is hiring 3 PHRN Prior Authorization Team Leaders in Pasig/Ortigas for onsite work. The role requires an Active PHRN license and 2+ years of healthcare BPO team leadership focusing on prior authorization processes. You will guide a team, ensure SLA achievement, and manage escalations while working night differential compensation....

Work set up: Onsite Opportunity – MCK Taguig, Cyber Sigma BuildingWork schedule: Weekdays Night Shift schedule, Fixed Weekends OffResponsibilitiesEffectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the validity of such denials in a timely manner -- Should conduct comprehensive reviews of...

WITH SIGNING BONUS!*Setup: On-site in Ortigas, PasigSchedule: Shifting schedule (predominantly night shift) Role Requirements: Must have an active PHRN licenseWith BPO experience, at least 1 year in prior authorization OR 1 year eligibility, claims, and benefits (payer)Good English communication skillsKnowledge of healthcare regulations and...

On-site - Quezon City 1-3 Yrs Exp Bachelor Full-time Job Description Medical Reimbursement We are seeking a licensed Registered Nurse to join our Clinical Analyst team. The successful candidate will review patient medical records, conduct clinical assessments, maintain accurate healthcare documentation, and collaborate with multidisciplinary teams to support...

On-site - Quezon City 1-3 Yrs Exp Bachelor Full-time Job Description Medical Reimbursement We are seeking a licensed Registered Nurse to join our Clinical Analyst team. The successful candidate will review patient medical records, conduct clinical assessments, maintain accurate healthcare documentation, and collaborate with multidisciplinary teams to support...

On-site - Quezon City 1-3 Yrs Exp Bachelor Full-time Job Description Medical Reimbursement We are seeking a licensed Registered Nurse to join our Clinical Analyst team. The successful candidate will review patient medical records, conduct clinical assessments, maintain accurate healthcare documentation, and collaborate with multidisciplinary teams to support...