Admin Support Staff

Desired Competencies (Technical/Behavioral Competency)

Must-Have**

 Active Philippine RN license

 At least 2 years in Business/Clinical Process Outsourcing and

prior auth experience preferred

Good-to-Have

 Certified US Nursing License

 Strong data entry, system navigation, and attention to detail

 Comfortable with repetitive workflows and client-specific

systems

SN Responsibility of / Expectations from the Role

1 Gather clinical and insurance documentation required for prior auth submissions

2 Verify patient eligibility and benefits via payer websites or calls

3 Input data into forms and maintain case records in client systems

4 Track request status and communicate updates to nursing and provider teams

5 Handle outbound and inbound calls

This role supports behavioral and mental health operations, primarily focused on psychiatric

medication prior authorizations, mental health-related forms, and care coordination. Team members regularly interact with patients, Psychiatrists, Nurse Practitioners, Patient Care Coordinators, pharmacies, insurance companies, and external vendors.

The position involves a combination of:

 Inbound and outbound calls

 Email management

 Documentation and case processing

 Coordination with healthcare stakeholders

Employees are expected to meet a 24-hour turnaround time (TAT) while maintaining high

productivity, accuracy, quality, and compliance standards. Given the impact on patient care and

medication access, attention to detail is critical.

Additional Expectations for USRNs

USRNs may be cross-trained to support patient message reviews and clinical triage functions to

ensure coverage during PTOs, LOAs, resignations, or business demands.

Responsibilities may include:

 Reviewing and triaging patient concerns

 Assessing symptoms and medication side effects

 Supporting clinical escalations and care coordination

 Managing high-risk behavioral health situations, including potential suicidal ideation cases that may require emergency escalation protocols

Success in this role requires:

 Strong clinical judgment and critical-thinking skills

 Sound decision-making and risk assessment

 Excellent communication and patient interaction skills

 Accurate and thorough clinical documentation

 Ability to remain professional, empathetic, and composed in sensitive and high-pressure

situations

This is a fast-paced, high-accountability healthcare environment where patient safety, quality,

confidentiality, and regulatory compliance are top priorities.