Health Operations Analyst — RN Licensed (Night)

Accenture in the Philippines; Taguig; On-site; PHP 279,000 - 446,000; Full time

Job summary

Accenture in the Philippines seeks a Health Operations Analyst to support health services with night shift hours from Taguig Uptown Bonifacio Tower 3. You will handle calls, e-Reviews, and data entry, verify eligibility and benefits, and coordinate with clinicians for prior authorizations.

Applicants must hold a Philippine RN license and have at least 3 months of clinical experience, ideally within healthcare operations or utilization management. On-site role with return-to-office setup.

Qualifications

• Hold a current Philippines Registered Nurse license.
• At least 3 months of clinical experience, including internships or volunteer work.
• Experience in healthcare settings such as Utilization Management or Health Insurance is a plus.

Responsibilities

• Manages incoming/outgoing calls, e-Reviews, and/or faxes with data entry into client system.
• Verifies eligibility and benefits and determines contract terms.
• Performs provider radius search and follows up on referrals.
• Check benefits for facility-based treatment and obtain intake information.
• Process requests for pre-certification and/or prior authorization using scripts.
• Enter data into client systems and route as appropriate.
• Match fax/clinical records with the correct case and consolidate inputs for approval.
• Generate letters as directed by the client and manage workflow in the system.
• Refer cases requiring clinical review to a nurse reviewer and ensure accuracy.
• Assign cases to the correct queue and conduct outbound calls for additional clinical information.

Skills

Data entry

Telephone handling

Clinical experience

RN license

Prior Authorization

Provider outreach

Education

Registered Nurse license (PH)

Job description

Accenture in the Philippines seeks a Health Operations Analyst to support health services with night shift hours from Taguig Uptown Bonifacio Tower 3. You will handle calls, e-Reviews, and data entry, verify eligibility and benefits, and coordinate with clinicians for prior authorizations.

Applicants must hold a Philippine RN license and have at least 3 months of clinical experience, ideally within healthcare operations or utilization management. On-site role with return-to-office setup.