PHRN Prior-Authorization | WFH

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced PHRN to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account Specific Roles and Responsibilities

• Receive and review claims requiring Prior Authorization.
• Access and utilize the CMM key to complete required clinical questionnaires.
• Locate and extract appropriate clinical information from PCC (PointClickCare) to support PA submissions.
• Accurately complete and submit Prior Authorization requests to health plans when applicable.
• Maintain accurate documentation of all actions taken within required systems.
• Ensure compliance with payer guidelines, company policies, and regulatory standards.
• Meet productivity and turnaround time expectations.

Requirements

• Must be a registered PHRN (must be active)
• with 1 - 2 years' bedside/clinical experience
• Knowledge with US Healthcare Insurance (Prior Authorization) is a PLUS
• Must be keen to details
• Excellent verbal and written English skills
• Must be residing within GMA (Greater Manila Area)
• Amenable working night shifts

Benefits

What can we offer you?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid time off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our Commitment To You

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all-inclusive environment where everyone thrives