Phrn - Prior Authorization Nurse

Position Summary

The Prior Authorization Nurse (PHRN) will support the review and submission of prior authorization requests for behavioral health treatments, medications, or services. The nurse will review clinical documentation to ensure accuracy and medical necessity, complete required payer forms, and work closely with administrative support staff to track and follow up on all submitted requests.

Key Responsibilities

- Review patient records and provider notes to validate clinical necessity

- Complete prior authorization forms and submit to payers via online portals or fax

- Follow up on status of submitted requests and escalate delays appropriately

- Maintain documentation accuracy and compliance with turnaround time requirements

Requirements

- Active PHRN license

- Minimum 4 years of experience in utilization management, prior authorization

- Familiarity with U.S. healthcare and payer systems

- Detail-oriented with strong communication and documentation skills

Job Type: Full-time

Pay: Php30,000.00 - Php65,000.00 per month

Benefits:

• Health insurance

Application Question(s):

• Notice Period:
• Current and Expected Salary:

License/Certification:

• PHRN/USRN Certificate (Preferred)

Work Location: In person