PHRN Medical Billing (BPO Exp) - Ortigas | WITH SIGNING BONUS!

TASQ Staffing Solutions; Pasig; Sur place; Plein temps

Avantages offerts par ce poste

Signing bonus

Résumé du poste

A healthcare solutions provider seeks a Coverage and Access Specialist in Pasig City. The role involves interacting with insurance payers for benefit verifications and managing patient inquiries. Candidates must hold an active PHRN license, preferably with BPO experience in prior authorizations. Strong communication skills and compliance knowledge are essential. This position offers a shifting schedule, predominantly at night, and is 100% onsite. Joining the team provides valuable experience in a dynamic healthcare environment.

Qualifications

• Must have an active PHRN license.
• At least 1 year experience in prior authorization or eligibility, claims and benefits.
• Good communication skills in English.
• Knowledge of healthcare regulations and compliance.
• Ability to work independently and in a team.

Responsabilités

• Interact with insurance payer representatives for benefit verifications.
• Document payer interactions for patient coverage status.
• Maintain SME knowledge for assigned programs.
• Respond to inquiries across various communication channels.
• Manage assigned cases throughout the patient journey.

Connaissances

Active PHRN license

BPO experience in prior authorization

Good English communication skills

Knowledge of healthcare regulations

Ability to work independently

Description du poste

WITH SIGNING BONUS!*

Work setup: 100% Onsite (Ortigas, Pasig City)

Shift: Shifting schedule - predominantly Nightshift

Start Date: January 29, 2026

Responsibilities

Coverage and Access Specialist (PHRN)

• Professionally and compliantly interact with insurance payer representatives during outbound phone calls for benefit verifications (New BVs, Annual reverification BVs and Bridge Eligibility Checks) and coverage exception follow up calls (Prior Authorization (Pas), Non- Formulary Exceptions (NFEs) and Appeals)
• Volume and case type to be worked to be determined by Novartis, but in collaboration with supplier based on current SLAs within the PSC and expected agent productivity
• Accurately and concisely document payer interactions to inform cross-functional partners on the patients coverage status

Care Navigator (PHRN)

• Develop and maintain Subject Matter Expert (SME) level knowledge of the relevant brand and customer workstreams for the specific assigned program
• Learn and utilize protocols to respond to customer phone, chat, fax, SMS / text, mail, and e-mail inquiries as well as other communication channels in a prompt and courteous manner
• Professionally and compliantly interact with customers, relevant Novartis associates, and other external contacts during inbound and outbound phone calls
• Manage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required

Requirements

• Must have an active PHRN license
• PHRN with BPO experience at least 1 year in prior authorization or 1 year eligibility, claims and benefits (payer)
• Good English communication skills
• Knowledge of healthcare regulations and compliance
• Ability to work independently and as part of a team