pre authorization nurse

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...

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 ReviewRelevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment (preferred only, not...

ISTA Solutions in Makati invites applications for an experienced Healthcare CSR to join our expanding team. You will handle initial or pre-authorization via phone or email, respond to provider requests, and verify member benefits while supporting healthcare cases.The role requires at least 6 months of BPO experience in a US healthcare campaign, strong...

OverviewJob title: PH USRN Authorization NurseWork set up: Onsite in BGC TaguigWork shift: Night shiftBudget: 40K - 60K package (4-6 yrs)Headcount: 1Job DescriptionThe Prior Authorization Nurse (USRN) will support the review and submission of prior authorization requests for behavioral health treatments, medications, or services. The nurse will review...

A healthcare services provider located in Metro Manila is seeking an Authorization Representative. This entry-level position requires knowledge of medical terminology and experience in healthcare environments. Duties include obtaining pre-certifications and working with insurance companies. The role is full-time and onsite, aligned with US business hours....

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...

Tata Consultancy Services in the Philippines invites applications for a Prior Authorization Admin Support RN to coordinate and submit prior authorization requests end-to-end. You will gather patient information, verify coverage, and ensure documentation is correctly uploaded to payer portals.Responsibilities include verifying eligibility, entering data into...

Accenture in the Philippines is seeking a Health Operations Associate for a return-to-office setup in Quezon City. The role involves eligibility checks, case routing, and high-volume provider communications to support clinical and administrative processes.Ideal candidates will have a college degree or high school diploma with BPO experience, excellent...

Prior Authorization Specialist (PHRN - Registered Nurse)Job Openings Prior Authorization Specialist (PHRN - Registered Nurse)About the job Prior Authorization Specialist (PHRN - Registered Nurse)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...

DescriptionISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare CSR to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a...

A healthcare consulting firm in Taguig is looking for a PHRN – Clinical Authorization specialist. This role involves verifying insurance eligibility, managing authorizations for medical services, and documentation of medical necessity. Candidates should have a BS Nursing degree and at least 6 months of relevant experience. This opportunity is onsite with a...

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,...

The PH Registered Nurse role at Shearwater Health in Taguig is designed to ensure quality care and efficient processing of client requests. You will coordinate department processes and perform routine service authorizations through telephone and online channels.Ideal candidates hold an active Philippine nursing license, have at least 6 months of bedside...

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare CSR to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused...

CW Marketing & Development Corporation is seeking a qualified nurse to join our health services team in the Philippines. You will assess employee health, manage pre-employment medical screenings, and support wellness initiatives across the organization.The role covers dispensing and safekeeping of medicines, delivering first aid, maintaining nursing records,...

Dempsey Resource Management Inc. is seeking a licensed nurse (BSN) to render medical services on a monthly-post basis. The role involves establishing rapport with patients and providing comprehensive perioperative care across pre-, intra-, and post-operative stages. The ideal candidate will administer medications, perform nebulization, assist in minor...

Dempsey Resource Management Inc. is seeking a licensed nurse (BSN) to render medical services on a monthly-post basis. The role involves establishing rapport with patients and providing comprehensive perioperative care across pre-, intra-, and post-operative stages.The ideal candidate will administer medications, perform nebulization, assist in minor...

SROCI is seeking a licensed nurse to provide medical services and dispense medications for company personnel at our Ortigas/Mandaluyong site. The role includes on-site first aid, pre-employment medical evaluations, and maintaining medical records.You will also support HRD clerical duties and other tasks as assigned, with shifting schedules. Qualifications...

CW Marketing & Development Corporation is seeking a qualified nurse to join our health services team in the Philippines. You will assess employee health, manage pre-employment medical screenings, and support wellness initiatives across the organization. The role covers dispensing and safekeeping of medicines, delivering first aid, maintaining nursing...

Location: Med‑Metrix Pasig, National Capital Region, Philippines Position Authorization Representative Benefits 8‑Hour Shifts, Fixed Weekends Off Day 1 HMO with 2 dependents covered for FREE Group Life Insurance Medical Cash Allowance Rice Allowance Clothing Allowance Holiday Gift Bereavement Assistance Free Lunch Daily Paid Time Off Training and Staff...