PHRN AR Executive
Job Summary
An Accounts Receivable Executive with a PH Registered Nurse license and hospital experience is needed to work in healthcare-related financial operations. Responsibilities include prior authorization processing, medical documentation review, and insurance coordination. Candidates must be a BSN graduate with an active PHRN license and relevant hospital experience.
Responsibilities
- Prior Authorization Processing
- Medical Documentation Review
- Insurance Coordination and Claims Management
Required Skills
- PHRN license and BSN degree
- 1-2 years hospital experience
- Medical terminology knowledge
Job Details
Job Responsibilities
Prior Authorization Processing: Review and process authorization requests from healthcare providers.
Medical Documentation Review: Assess patient records to ensure compliance with insurance requirements.
Insurance Coordination: Communicate with payers to obtain approvals for medical procedures.
Claims Management: Assist in resolving denied claims and ensuring timely reimbursements.
Customer Service: Handle inquiries from healthcare providers and insurance companies.
Compliance & Accuracy: Ensure adherence to medical billing regulations and maintain accurate records.
Qualifications
Education: Bachelor of Science in Nursing (BSN) with an active PHRN license.
Experience: At least 1–2 years of hospital experience, preferably in acute care settings (must be 2019 onwards)
Skills:
- Strong understanding of medical terminology, anatomy, and physiology.
- Experience in prior authorization and insurance claims processing.
- Proficiency in computer applications (Word, Outlook, PDF, and medical billing software).
- Excellent communication and customer service skills.
- Ability to multi-task, prioritize, and work in a fast-paced environment.