Cardiac Prior Authorization Specialist (PHRN) – Onsite

Omega Healthcare Management Services Inc.; Eastern Manila District; On-site; PHP 223,000 - 312,000; Full time

Job summary

Omega Healthcare Management Services Inc. is seeking a Precertification Coordinator to obtain prior authorizations and referrals for cardiac procedures. You will engage payers, review clinical documentation, and ensure timely processing of authorizations, working closely with provider offices.

The role emphasizes attention to detail, solid medical terminology knowledge, and strong communication skills, with onsite work in Ortigas and ongoing interaction with payer staff.

Qualifications

• PHRN license must be valid and current.
• Onsite work at Ortigas is required.
• Minimum 1 year of experience in BPO or healthcare admin.
• PHRN with prior authorization experience is preferred.
• Strong attention to detail and communication skills.
• Proficiency with MS Word, Outlook and PDF workflows.

Responsibilities

• Prioritize incoming authorization and referral requests by queue urgency.
• Review patient charts and clinical information related to the service.
• Obtain and follow up on authorizations/referrals from payers via calls, portals or faxes.
• Respond to payer clinical questions to proceed with authorization requests.
• Coordinate payer peer-to-peer review requirements and relay results to providers.
• Cater inbound payer calls and review voicemail messages as needed.

Skills

Anatomy & physiology

Medical terminology

Multispecialty authorizations

Medical coding

Customer service

Verbal and written communication

Attention to detail

Adaptability

Team collaboration

Education

PHRN license

Tools

Microsoft Word

Outlook

PDF workflows

Job description

Omega Healthcare Management Services Inc. is seeking a Precertification Coordinator to obtain prior authorizations and referrals for cardiac procedures. You will engage payers, review clinical documentation, and ensure timely processing of authorizations, working closely with provider offices.

The role emphasizes attention to detail, solid medical terminology knowledge, and strong communication skills, with onsite work in Ortigas and ongoing interaction with payer staff.