PHRN Utilization Review (Onsite) | 1 Yr UR + 2 Yrs Acute Hospital

apartmentOmega Healthcare Management Services Inc. placePasig scheduleFull-time calendar_month5/1/26

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

With an active PHRN license.
Experience: At least 1–2 years of hospital experience, preferably in acute care setting.
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.

business_centerHigh salary

Officer 1, Global Payments Team

apartmentIQ-EQplacePasig

in time reporting system Qualifications ABOUT YOU Educational Background: • Bachelor's degree in business, finance, or related field preferred Professional Experience: • 0- 1 year of experience in payment processing, banking, or administrative support...

starFeatured

SAP SD & MM Support Analyst – Level 1 (L1)

apartmentTrinity Workforce Solutions, Inc.placeQuezon City, 10 km from Pasig

Job Description The SAP SD & MM Level 1 (L1) Support Analyst provides first-line functional support for Sales and Distribution (SD) and Materials Management (MM) modules. The role focuses on incident logging, initial troubleshooting, and resolution...

electric_boltImmediate start

Loan Analyst | Day 1 HMO

apartmentIQ-EQplacePasig

description": " Company Description ABOUT IQ-EQ We're a leading Investor Services group offering end-to-end services in administration, accounting, reporting, regulatory and compliance needs of the investment sector worldwide. We employ a global...