Nurses - Ortigas

About the job: PHRN - Medical Billing (100% Onsite in Ortigas)
WITH SIGNING BONUS! *

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

Shift: Shifting schedule, predominantly night shift

Start Date: December 15, 2025; January 12, 2026; January 19, 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).
• The 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 patient's 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
• With or without BPO experience
• Good English communication skills
• Knowledge of healthcare regulations and compliance
• Ability to work independently and as part of a team