Patient Support (PHRNs) - Pasig (Medical Billing)

About the job PHRN - Medical Billing (100% Onsite in Ortigas) | To Start on January 29, 2026

WITH SIGNING BONUS!*

Work setup: 100% Onsite (Ortigas, Pasig City)

Shift: Shifting schedule - predominantly Nightshift

Start Date: January 29, 2026

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 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

Requirements:

Must have an active PHRN license

PHRN 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