PHRN Specialist (Healthcare Account)

Lennor Metier; Pasig; On-site; PHP 420,000 - 540,000; Full time

Job summary

Lennor Metier is seeking a PHRN Specialist (Healthcare Account) based in Pasig, Philippines. You will manage patient cases across the healthcare journey, including insurance navigation and benefit verification, while coordinating with payers and patients to resolve coverage issues.

You will document interactions and meet established SLAs, collaborating with internal teams to improve processes. This onsite role requires a Philippine Registered Nurse license, at least two years acute hospital

Qualifications

• Active Philippine Registered Nurse (PHRN) license.
• Minimum of two years of acute hospital clinical experience.
• Proven experience working in a US Healthcare BPO setting.
• Strong verbal and written communication skills.
• Detail-oriented with strong organizational and documentation skills.
• Willing to work onsite in Ortigas.
• Amenable to a fixed night shift schedule.

Responsibilities

• Conduct outbound calls to payers for benefit verifications, prior authorizations, non-formulary exceptions, appeals, and bridge eligibility checks.
• Contact patients directly when needed to facilitate coverage resolution.
• Accurately document all interactions and update case records in a timely manner.
• Follow job aids, case workflows, and escalation protocols.
• Meet established SLAs, KPIs, productivity, and quality standards.
• Identify and report adverse events in accordance with compliance requirements.
• Manage cases across the patient journey, including insurance navigation and financial assistance support.
• Respond promptly to inquiries across phone, chat, email, SMS, fax, and other channels.
• Conduct conference calls with payers and patients to resolve access barriers.
• Collaborate with internal stakeholders and contribute to process improvements.

Skills

Verbal and written communication

Detail-oriented

US Healthcare BPO experience

Education

PHRN license

Job description

About the role

PHRN Specialist (Healthcare Account) based in Pasig, Philippines. The role involves managing patient cases across the healthcare journey, including insurance navigation, benefit verification, and financial assistance support. You will conduct outbound calls to payers and contact patients directly to facilitate coverage resolution and manage access barriers.

Key responsibilities

• Conduct outbound calls to payers for benefit verifications, prior authorizations, non-formulary exceptions, appeals, and bridge eligibility checks
• Contact patients directly when needed to facilitate coverage resolution
• Accurately document all interactions and update case records in a timely manner
• Follow job aids, case workflows, and escalation protocols
• Meet established SLAs, KPIs, productivity, and quality standards
• Identify and report adverse events in accordance with compliance requirements
• Manage cases across the patient journey, including insurance navigation and financial assistance support
• Respond promptly to inquiries across phone, chat, email, SMS, fax, and other channels
• Conduct conference calls with payers and patients to resolve access barriers
• Collaborate with internal stakeholders and contribute to process improvements

About you

• Active Philippine Registered Nurse (PHRN) license
• Minimum of two (2) years of acute hospital clinical experience
• Proven experience working in a US Healthcare BPO setting
• Strong verbal and written communication skills
• Ability to work efficiently in a fast-paced, high-pressure environment
• Detail-oriented with strong organizational and documentation skills
• Demonstrates professionalism, accountability, and adaptability
• Willing to work onsite in Ortigas
• Amenable to a fixed night shift schedule

About us

Lennor Metier is a specialized executive search and professional recruitment firm helping organizations hire leadership, finance, accounting, human resources, sales, marketing, supply chain, operations, and business-critical talent.