PHRN with BPO Experience | with Signing Bonus | Ortigas Pasig

Omega Healthcare Management Services, Inc.; Pasig; On-site; PHP 334,800 - 446,400; Full time

Job summary

A leading healthcare BPO provider in Metro Manila seeks an Accounts Receivable Executive. The role requires a registered nurse with hospital experience, focusing on medical documentation, insurance coordination, and claims management. Ideal candidates should possess a strong understanding of medical terminology and excellent customer service skills. This position offers an opportunity to work in a dynamic environment while ensuring compliance with billing regulations.

Qualifications

• Active PH Registered Nurse (PHRN) license required.
• At least 1–2 years of hospital experience, preferably in acute care settings.

Responsibilities

• Review and process authorization requests from healthcare providers.
• Assess patient records for compliance.
• Communicate with payers for approvals.
• Assist in resolving denied claims.
• Handle inquiries from providers and insurers.
• Ensure adherence to medical billing regulations.

Skills

Medical terminology

Anatomy and physiology

Prior authorization

Insurance claims processing

Communication skills

Customer service

Multi-tasking

Proficiency in computer applications

Education

Bachelor of Science in Nursing (BSN)

Tools

Medical billing software

Word

Outlook

PDF

Job description

Work with the No. 1 Healthcare BPO

Accounts Receivable (AR) Executive with a PH Registered Nurse (PHRN) license and hospital experience typically works in healthcare-related financial operations, often within business process outsourcing (BPO) or medical billing roles. Here’s a general job description:

Job Responsibilities

• Prior Authorization Processing: Review and process authorization requests from healthcare providers.
• Medical Documentation Review: Assess patient records to ensure compliance with insurance requirements.
• Insurance Coordination: Communicate with payers to obtain approvals for medical procedures.
• Claims Management: Assist in resolving denied claims and ensuring timely reimbursements.
• Customer Service: Handle inquiries from healthcare providers and insurance companies.
• Compliance & Accuracy: Ensure adherence to medical billing regulations and maintain accurate records.

Qualifications

• Education: Bachelor of Science in Nursing (BSN) with an active PHRN license.
• Experience: At least 1–2 years of hospital experience, preferably in acute care settings (must be 2019 onwards)
• Skills:
• Strong understanding of medical terminology, anatomy, and physiology.
• Experience in prior authorization and insurance claims processing.
• Proficiency in computer applications (Word, Outlook, PDF, and medical billing software).
• Excellent communication and customer service skills.
• Ability to multi-task, prioritize, and work in a fast-paced environment.