PHRN (Philippine Registered Nurse)

₱20000-30000 per month
Entry Level / Junior, Apprentice


  • Must have an active PRC Nursing License..
  • Must have at least 3 months of clinical experience as a Registered Nurse
  • Must be willing to work at the office or WFH based on company business needs.
  • Must have good computer skills and can type at least 25wpm.
  • Must have a stable active hard wired internet connection at home.

Job Responsibilities

  • Review service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts.
  • Route cases to client medical staff for further review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
  • Work with clinical reviewers and medical directors in interpreting appropriateness of care and conducting PSCCR claims review utilizing the member’s benefit contract and health plan guidelines.
  • Process incoming requests, collection of information needed for review form providers.
  • Determine contract and benefit eligibility, obtain intake demographic information from callers and/or faxes.