job description
Join Omega Healthcare Management Services Inc. as a Prior Authorization Registered Nurse (PHRN) and play a pivotal role in ensuring patients receive timely access to critical healthcare services. This remote opportunity allows you to work from the stunning locations of Bali, Indonesia, while contributing to a mission-driven organization that values patient advocacy and operational excellence.
As a PHRN, you will serve as the bridge between healthcare providers, insurance companies, and patients, verifying benefits, coordinating authorizations, and documenting cases with precision. Your expertise will directly impact patient care by streamlining approvals and reducing delays in treatment. With a signing bonus of up to $40,000, this role offers both financial rewards and the satisfaction of making a difference in the healthcare system.
Omega Healthcare is a global leader in revenue cycle management and healthcare solutions, committed to delivering exceptional service while fostering a supportive and collaborative work environment. If you are a licensed nurse with a passion for detail, strong communication skills, and a desire to work in a dynamic, remote setting, we invite you to apply.
Responsibility
- Verify patient insurance benefits and eligibility for medical services, treatments, and procedures.
- Obtain and process prior authorizations from insurance providers to ensure timely approval for patient care.
- Liaise with healthcare providers, insurance companies, and patients to clarify requirements and resolve authorization issues.
- Document all interactions, authorizations, and case details accurately in electronic health records (EHR) and internal systems.
- Conduct outbound and inbound calls to gather necessary information and provide updates on authorization status.
- Educate patients and providers on insurance policies, coverage limitations, and authorization processes.
- Monitor and follow up on pending authorizations to prevent delays in patient treatment.
- Collaborate with cross-functional teams to improve authorization workflows and reduce denials.
Qualifications
- Valid Registered Nurse (RN) license in the Philippines (PHRN) or equivalent international certification.
- Minimum of 2 years of experience in prior authorization, utilization review, or case management in a healthcare setting.
- Strong knowledge of medical terminology, insurance policies, and healthcare regulations (e.g., HMO, Medicare, Medicaid).
- Excellent verbal and written communication skills in English, with the ability to explain complex information clearly.
- Proficiency in using EHR systems, Microsoft Office, and healthcare management software.
- Detail-oriented with exceptional organizational and time-management skills to handle high-volume caseloads.
- Ability to work independently in a remote setting with reliable internet connectivity.
- Customer-service focused with a compassionate and patient-centric approach.