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...

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...

About the job PHRN - Prior Authorization Quality Auditor hiring Clinical Authorization Process. Onsite, Night Shift, Mon-Friday Qualifications Must hold an active PHRN license (not a USRN license holder) Relevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment; alternatively, 4 to 7 years of specialized experience in...

About the job Prior Authorization Nurse - PHRN (QA) Position: Clinical/Prior Authorization - Quality Auditor Qualifications: Must hold an active PHRN license (not a USRN license holder) Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review Relevant experience as a Quality Auditor in Clinical Services...

Cognizant is a global organization serving clients across multiple industries with a deep set of offerings provided by our practice areas and supported by corporate and enabling functions. Employing roughly 270,000 talented associates worldwide, Cognizant is dedicated to anticipating and solving clients’ toughest problems and enabling them to thrive in the...

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...

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,...

AGS Health Philippines, Inc. seeks a skilled Utilization Review Specialist to verify insurance coverage, obtain pre-authorizations, and ensure medical necessity documentation complies with HIPAA regulations.The role emphasizes accurate medical recordkeeping and timely coordination with insurers and care providers. Applicants should hold a PHRN license and...

Join us to be our next Clinical Appeals DRG Nurses in Quezon City and Cebu City!Qualifications & experienceClinical Appeals Writing Experience (6 months to 1+ year) familiar with DRG downcode or coding appeals)Familiar with use of MCG /InterQual guidelines /ICD-10 coding guidelinesMedical Coding, CDI, or DRG downcode experienceMS-DRG (Medicare Severity; the...

Join us to be our nextClinical Appeals DRG Nurses in Quezon City and Cebu City!Qualifications & experience Clinical Appeals Writing Experience (6 months to 1+ year) familiar with DRG downcode or coding appeals) Familiar with use of MCG /InterQual guidelines /ICD-10 coding guidelines Medical Coding, CDI, or DRG downcode experience MS-DRG (Medicare Severity;...

HRTX in the Philippines seeks a Clinical Documentation Improvement Specialist to enhance the quality and completeness of medical records. You will work with physicians, coders, and the health team to ensure documentation reflects the patient’s true clinical picture and supports accurate coding. This role requires active PHRN and USRN licenses, 3–5 years...

Are you aPhilippine Registered Nurseready to take your career beyond the bedside? Step into a role where your clinical expertise meets innovation, compliance, and global impact.AtConcentrix , we don’t just offer jobs — we buildextraordinary journeys . Join a workplace where you’ll collaborate with industry champions, sharpen your skills, and thrive in...

Are you a Philippine Registered Nurse ready to take your career beyond the bedside? Step into a role where your clinical expertise meets innovation, compliance, and global impact.At Concentrix, we don’t just offer jobs — we build extraordinary journeys. Join a workplace where you’ll collaborate with industry champions, sharpen your skills, and thrive...

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...

About the job Prior Authorization Nurse - PHRN (QA)Position: Clinical/Prior Authorization - Quality AuditorQualifications:Must hold an active PHRN license (not a USRN license holder)Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization ReviewRelevant experience as a Quality Auditor in Clinical Services within a...

About Omega Healthcare Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) is an AI-driven healthcare solutions company that partnersacross the healthcare ecosystem to deliver breakthrough resultsby reimagining and elevating revenue operations.Powered by the Omega Digital Platform®, our agentic AI engineleverages adaptive intelligence...

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...