phrn (prior authorization/eligibility & benefits) | kickst art your 2026TASQ Staffing Solutions
Setup: On-site in Ortigas, Pasig
Schedule: Shifting schedule (predominantly night shift)Role Requirements:
Must have an active PHRN license
With BPO experience, at least 1 year in prior authorization OR 1 year eligibility, claims, and benefits (payer)
Good English communication skills
Knowledge of healthcare regulations and compliance
Ability to work independently and as part of a team * Start date: Jan. 29, 2026
Signing bonus - Terms and conditions apply
Responsibilities:Coverage and Access Specialist (PHRN)
Professionally and compliantly interact with insurance payer representatives during outbound phone calls for benefit verifications (New BVs, Annual reverification BVs, and Bridge Eligibility Checks) and coverage exception follow-up calls (Prior Authorization (PAS), Non-Formulary Exceptions (NFEs,) and Appeals)
Volume and case type to be worked to be determined by Novartis, but in collaboration with the supplier, based on current SLAs within the PSC and expected agent productivity
Accurately and concisely document payer interactions to inform cross-functional partners on the patients' coverage status
Care Navigator (PHRN)
Develop and maintain Subject Matter Expert (SME) level knowledge of the relevant brand and customer workstreams for the specific assigned program
Learn and utilize protocols to respond to customer phone, chat, fax, SMS/text, mail, and e-mail inquiries, as well as other communication channels, in a prompt and courteous manner
Professionally and compliantly interact with customers, relevant Novartis associates, and other external contacts during inbound and outbound phone calls
Manage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage, and follow-up where required
TASQ Staffing Solutions
Other Info
Permanent
Full-time
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TASQ Staffing Solutions
About the company
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About the company
TASQ Staffing Solutions jobs
Unit 501 Cattleya Condominium, Salcedo St. 235, Legazpi Village, Makati City