PHRN - Medical Billing (100% Onsite in Ortigas) | To Start on January 29, 2026\n\nWITH SIGNING BONUS!*\n\nWork setup: 100% Onsite (Ortigas, Pasig City)\n\nShift: Shifting schedule - predominantly Nightshift\n\nStart Date: January 29, 2026\n\nResponsibilities:\n\nCoverage and Access Specialist (PHRN)\n\nProfessionally 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)\n\nVolume 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\n\nAccurately and concisely document payer interactions to inform cross-functional partners on the patients coverage status\n\nCare Navigator (PHRN)\n\nDevelop and maintain Subject Matter Expert (SME) level knowledge of the relevant brand and customer workstreams for the specific assigned program\n\nLearn 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\n\nProfessionally and compliantly interact with customers, relevant Novartis associates, and other external contacts during inbound and outbound phone calls\n\nManage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required\n\nRequirements:\n\nMust have an active PHRN license\n\nPHRN with BPO experience at least 1 year in prior authorization or 1 year eligibility, claims and benefits (payer)\n\nGood English communication skills\n\nKnowledge of healthcare regulations and compliance\n\nAbility to work independently and as part of a team