Registered Nurse (PHRN)

We are seeking a Philippine-licensed Registered Nurse to join our growing healthcare BPO team. The successful candidate will leverage clinical expertise to provide high-quality support to patients, healthcare providers, and insurance partners in a professional and efficient manner. This role is ideal for nurses who wish to apply their clinical background in a dynamic corporate setting while developing new skills in healthcare operations and customer engagement.

Key Responsibilities:

• Handle inbound and outbound calls, emails, or chats related to healthcare services, insurance verification, medical claims, utilization review, or case management.
• Review, evaluate, and process clinical information according to established policies and medical guidelines.
• Coordinate with healthcare professionals, patients, and internal teams to ensure accurate communication and efficient resolution of cases.
• Document all interactions accurately and maintain confidentiality in compliance with HIPAA and company data privacy policies.
• Assist in preauthorization, medical coding support, benefits eligibility, or other specialized healthcare processes (depending on account).
• Participate in quality assurance activities and continuous process improvement initiatives.
• Maintain an up-to-date understanding of medical terminologies, procedures, and healthcare documentation standards.

Qualifications:

• Must be a Registered Nurse (RN) in the Philippines, with a valid PRC license.
• At least 1 year of clinical experience in a hospital, clinic, or similar healthcare setting (e.g., bedside, outpatient, emergency, etc.).
• Preferably with experience in a BPO healthcare account (utilization management, claims review, prior authorization, etc.), but not required.
• Strong English communication and interpersonal skills.
• Excellent attention to detail and documentation accuracy.
• Proficient in MS Office applications and comfortable working with multiple systems or EMR platforms.
• Willing to work on night shifts, weekends, or holidays as needed.

What We Offer:

• Competitive salary and performance incentives.
• HMO coverage for employee and dependents.
• Paid training and continuous learning opportunities.
• Career growth and promotion pathways within the healthcare BPO industry.
• Safe and inclusive work environment.