Our brand, Lennor Metier Consulting, a DOLE-licensed headhunting and recruitment agency in the Philippines, is proud to partner with a
global provider of revenue cycle management (RCM) and specialized clinical services for organizations in their search for a
PHRN Specialist based in
Ortigas.
Salary Range: 40,000 - 50,000 (with Sign-on Bonus)
Start Date: March 23, 2026
Work Setup: Onsite
Shift Schedule: Night Shift (Mon-Fri, fixed weekends off)
Location: Ortigas
The role
The
PHRN Specialist plays a vital role in supporting patient access, insurance navigation, and case management activities within a US healthcare program. This position ensures accurate benefit verification, coverage resolution, and patient support through compliant engagement with payers, patients, and cross-functional stakeholders.
Your 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.
What We're Looking For
- Active Philippine Registered Nurse (PHRN) license.
- Minimum of one (1) 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.
Ready to take the next step in your career Submit your application now!
- We kindly request your patience as we receive a significant number of applications. Rest assured that our team will update your application's status soon. In the meantime, we encourage you to follow our LinkedIn page to stay informed about future opportunities and company updates.
