PH USRN - Prior Authorization Nurse
Gratitude IncPH USRN - Prior Authorization Nurse
Job Description
Key Skills
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Job title: PH USRN Authorization Nurse
Work set up: Onsite in BGC Taguig
Work shift: Night shift
Budget: 40K - 60K package (4-6 yrs)
Headcount: 1
Job Description:
The Prior Authorization Nurse (USRN) will support the review and submission of prior
authorization requests for behavioral health treatments, medications, or services. The nurse will review clinical documentation to ensure accuracy and medical necessity, complete required payer forms, and work closely with administrative support staff to track and follow up on all submitted requests.
Key Responsibilities
Review patient records and provider notes to validate clinical necessity
Escalate cases appropriately to medical director
Complete prior authorization forms and submit to payers via online portals or fax
Coordinate with support staff to gather documentation and verify benefits
Follow up on status of submitted requests and escalate delays appropriately
Maintain documentation accuracy and compliance with turnaround time requirements
Requirements
Active USRN license, based in the Philippines
Minimum 4 years of experience in utilization management, prior authorization
Familiarity with U.S. healthcare and payer systems
Detail-oriented with strong communication and documentation skills
Immediate joiners
Must not be a former or current employee of the client
Can work onsite in BGC Taguig
Role
US Registered Nurse
Timings
Night Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Process
Non-Voice
Functional Area
ITES / BPO / Customer Service
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
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