Tasq-work·15 days ago
15 days ago
PHRN - Grievance & Appeals Specialist (Hybrid)
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What you'll do
- Clinical Review & Documentation: Analyzing medical records for accuracy, compliance, and appropriateness of care.
- Claims Processing: Determining patient eligibility, validating medical claims, and managing insurance coverage.
- Utilization Management: Reviewing treatment plans against medical policies to ensure cost-effective care.
- Case Management & Liaison: Communicating with healthcare providers and patients to facilitate care and resolve inquiries.
What they're looking for
- PHRN with Active license
- Must have at least 1 year grievance & case appeals experience
- Back-office (Non-voice)
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Work Setup: Training is full onsite; once in production, 2x a week onsite (Taguig)
Work Schedule: Night shift
Start Date: October 13, 2026
Requirements:
- PHRN with Active license
- Must have at least 1 year grievance & case appeals experience
- Back-office (Non-voice)
Responsibilities:
- Clinical Review & Documentation: Analyzing medical records for accuracy, compliance, and appropriateness of care.
- Claims Processing: Determining patient eligibility, validating medical claims, and managing insurance coverage.
- Utilization Management: Reviewing treatment plans against medical policies to ensure cost-effective care.
- Case Management & Liaison: Communicating with healthcare providers and patients to facilitate care and resolve inquiries.
Company
Tasq-work
Taguig, Philippines
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