PH USRN - Prior Authorization Nurse

Gratitude Inc

1916 Views

4 months ago

PH USRN - Prior Authorization Nurse

2-6 Year(s)

15 - 60 Thousand p.m

Manila (Alabang Muntinlupa City, Makati, Pasay City, Pasig, Taguig)

Job Description

Key Skills

USRN hiring USRN Active USRN Mainland license Clinical Authorization

3 candidate(s) have already applied for this Job. Apply now

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.

Adaobi Okeke

Recruiter - Gratitude Inc

NA, nigeria

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