PHRN Specialist (Healthcare Account)

Lennor Group; Pasig; On-site; PHP 558,000 - 893,000; Full time

Job summary

Lennor Metier is recruiting a Registered Nurse (PHRN) to support Coverage & Access and Care Navigation for US healthcare clients. This role is onsite in Ortigas, Pasig, Philippines, requiring a fixed night shift and strong documentation skills.

The ideal candidate will hold an active PHRN license with at least two years of acute hospital experience and proven US healthcare BPO background, along with excellent verbal and written communication abilities suitable for fast-paced environments.

Qualifications

• Active Philippine Registered Nurse (PHRN) license is required.
• Minimum of two (2) years of acute hospital clinical experience.
• Proven experience in a US Healthcare BPO setting.
• Strong verbal and written communication skills.
• Ability to work efficiently in a fast-paced environment.
• Detail-oriented with solid documentation skills.
• Professional, accountable and adaptable.
• Willing to work onsite in Ortigas.
• Amenable to a fixed night shift schedule.

Responsibilities

• Coverage & Access: conduct outbound calls 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 timely.
• Follow job aids, case workflows, and escalation protocols.
• Meet SLAs, KPIs, productivity, and quality standards.
• Identify and report adverse events per compliance requirements.
• Care Navigation: manage cases across the patient journey including insurance navigation and financial assistance.
• Respond promptly to inquiries across phone, chat, email, SMS, fax, and other channels.
• Conduct conference calls with payers and patients to resolve access barriers.
• Ensure proper triage, follow-up, and case escalation when necessary.
• Collaborate with internal stakeholders and contribute to process improvements.
• Utilize technology and documentation systems to support case management.

Skills

PHRN license

Acute hospital experience

US Healthcare BPO

Verbal and written communication

Detail-oriented

Documentation skills

Professionalism

Night shift

On-site in Ortigas

Job description

Location:

Pasig, Philippines

Work Setup:

Onsite

Compensation Flexibility:

Open to negotiation for highly qualified candidates.

Key Responsibilities

• Coverage & Access
  • 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.

Care Navigation

• 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.
• Ensure proper triage, follow-up, and case escalation when necessary.
• Collaborate with internal stakeholders and contribute to process improvements.
• Utilize technology and documentation systems efficiently to support case management.

Required Qualifications

• Active Philippine Registered Nurse (PHRN) license.
• Minimum of two (2) year 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 Lennor Metier

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.

EQUAL OPPORTUNITY STATEMENT

Lennor Metier is committed to fostering an inclusive and equitable recruitment process. All qualified applicants will receive consideration based on their qualifications, experience, capabilities, and business requirements.

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