Job Description
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 ke y 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.
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
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
