Registered Nurse (PH)

The Role:

PHRN – Job Description

Position: Philippine Registered Nurse (PHRN)

Industry: Healthcare / BPO

Work Type: Onsite / Hybrid / Remote (depends on account)

Shift: Mostly Night Shift (US Healthcare Account)

Job Summary:

The PHRN will support US-based healthcare operations by reviewing clinical cases, processing claims, conducting utilization review, and ensuring medically appropriate and cost-effective care decisions. The role requires strong clinical judgment, excellent communication skills, and accurate documentation.

Key Responsibilities:

• Review medical records, clinical notes, and supporting documents to determine medical necessity and appropriateness of care.
• Process claims, pre-authorizations, and appeals based on established clinical guidelines and payer policies.
• Evaluate p...