Customer Service Representative - PHRN – REGISTERED NURSES

Private Advertiser; Pasay; Híbrido; PHP 420.000 - 540.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Sign-on bonus

Premium HMO

Performance incentives

Night differential

Work-from-home setup

Descripción de la vacante

Private Advertiser seeks a PHRN Nurse Associate in the Philippines to evaluate medical records, process insurance claims and perform utilization reviews. The role starts with onsite training before transitioning to a work-from-home setup.

We offer a sign-on bonus and opportunities to work with international healthcare accounts. Strong clinical assessment and documentation skills are essential for success in this position.

Formación

• Active Philippine Registered Nurse license (PRC).
• At least 1 year of clinical experience, excluding internship.
• Strong record review, clinical assessment and documentation skills.
• Good written and verbal communication skills.
• Willingness to work with international healthcare processes and accounts.

Responsabilidades

• Evaluate medical records for completeness and alignment with requirements.
• Process insurance claims and review supporting documentation.
• Perform utilization reviews for international healthcare or BPO accounts.
• Apply clinical knowledge and guidelines when assessing information.
• Document review findings accurately and escalate discrepancies when needed.
• Collaborate with healthcare operations to support timely case resolution.

Conocimientos

Medical record review

Clinical assessment

Documentation

Communication skills

International accounts

Educación

Philippine RN license (PRC)

Descripción del empleo

About the role

Join a healthcare or BPO account based in the Philippines as a PHRN Nurse Associate. You will apply your clinical knowledge to evaluate medical records, process insurance claims, and perform utilization reviews that support accurate, efficient, and quality-focused healthcare operations. The role includes onsite training before transitioning to a work-from-home setup.

SIGN-ON BONUS: ₱ 50,000

Key responsibilities

• Evaluate medical records for completeness, accuracy, and alignment with clinical and operational requirements.
• Process insurance claims and review supporting documentation.
• Perform utilization reviews for international healthcare or BPO accounts.
• Apply clinical knowledge and established guidelines when assessing healthcare information.
• Document review findings accurately and elevate discrepancies or complex cases when appropriate.
• Work collaboratively with healthcare operations and account teams to support timely case resolution.

What we're looking for

• Active Philippine Registered Nurse license issued by the Professional Regulation Commission.
• At least 1 year of clinical experience EXCLUDING clinical internship.
• Strong medical record review, clinical assessment, and documentation skills.
• Good written and verbal communication skills.
• Ability to work with international healthcare processes and accounts.
• BPO experience is an advantage but not required.
• Willingness to complete onsite training and transition to a work-from-home setup.

Additional Benefits

• Premium HMO coverage from Day 1 with coverage for 2 dependents.
• Performance incentives.
• Night differential.
• Work-from-home setup after onsite training