(ACTIVE) PHRN - Grievance & Case Appeals | Hybrid after Training in Taguig

Gratitude Inc

47 Views

4 days ago

(ACTIVE) PHRN - Grievance & Case Appeals | Hybrid after Training in Taguig

1-5 Year(s)

Manila

Quick Apply Apply

Job Description

Key Skills

Back office Operations Documentation Quality assurance PH - Registered Nurse claims Healthcare Operation Utilization Review Health Insurance Claims Processor Patient Care Grievances Support Experience active PHRN License Excellent clinical interpretation skills based on limited information provided along with a comprehensive understanding of medical terminology Case Appeals experience

19 candidate(s) have already applied for this Job. Apply now

Job Title: PHRN – Grievance & Case Appeals

Work Setup: Full onsite during training; hybrid (2x onsite per week) once in production

Work Schedule: Night Shift

Target Start Date: October 13, 2026

Job Summary

We are looking for Philippine Registered Nurses (PHRN) with experience in grievance and case appeals to join our healthcare operations team.

The role is primarily back-office/non-voice, focused on reviewing and handling healthcare-related grievances and case appeals while ensuring accuracy, compliance, and timely resolution.

Qualifications

Must be a PHRN with an active Philippine nursing license.

Must have an active Registered Nurse (RN) license.

At least 1 year of experience handling grievance and case appeals.

Experience in a back-office/non-voice healthcare process is required.

Willing to work on a night shift schedule.

Willing to attend full onsite training.

Once in production, must be willing to work onsite 2x per week.

Must demonstrate stable employment history. Candidates with frequent job changes, particularly multiple roles lasting less than one year, may not be considered.

Key Responsibilities

Review and evaluate healthcare-related grievances and case appeals.

Analyze case information, medical documentation, and supporting records.

Ensure cases are handled accurately and in accordance with established guidelines and procedures.

Prepare appropriate documentation and case resolutions.

Maintain confidentiality of patient and case information.

Meet established quality, productivity, and turnaround-time requirements.

Coordinate with relevant teams when additional information or clarification is required.

Recruitment Process

Qualified candidates will undergo the following process:

Talkpush Validation

Talkscore

Account Exam

HR Interview

Operations Interview

Job Offer

Prescreening Information

Recruiters should capture the following information during prescreening:

PHRN license validity date:

Years of experience in grievance and case appeals:

Educational attainment:

Salary expectation:

Last drawn salary:

Notice period:

Availability for the required work setup and night shift schedule:

Current location:

Important Work Setup Details

Training: 100% onsite

Production: Hybrid – 2 days onsite per week

Shift: Night shift

Target Start Date: October 13, 2026

Role

Nurse

Timings

Night Shift (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Hybrid

Process

Non-Voice

Functional Area

Medical Professional / Healthcare Practitioner / Technician

Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.

Bibi Hukkeri

Recruiter - Gratitude Inc

NA, india

0+ Followers

500+ Posts

View Profile

Interview Tips

Giving the VNA round?
What are the most important skills you acquired as a Soft Skills/VNA trainer?
How would you handle an irate customer?

Get the Best Jobs
on your Fingertips

Confidential

Manila, Philippines

Details