PHRN – Clinical Authorization

Overview

• Job title: PHRN – Clinical Authorization
• Work set up: Onsite Opportunity – MCK Taguig, Cyber Sigma Building
• Work schedule: Weekdays Night Shift schedule, Fixed Weekends Off
• Salary: 45K to 50K package if licensed PHRN, salary for approval if non-licensed

Responsibilities

• Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
• Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
• Review, request, follow up and secure authorizations for high dollar cost oncology chemotherapy drugs.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Review denials and follow up...