PHRN - Grievance & Appeals Specialist (Hybrid)
Full-time
Tasq Staffing Solutions, Inc.
Work Setup: Training is full onsite; once in production, 2x a week onsite (Taguig)
Start Date: Sept 15, 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.
Vacancy posted 7 days ago
Similar jobs that could be interesting for youBased on the PHRN - Grievance & Appeals Specialist (Hybrid) in Taguig vacancy
- ...InterQual criteria to determine if account meets criteria for appeal Should write an appeal letter to payer using appropriate clinical... ...trending of educational opportunities of the coding and CDI specialists, responding to client subject matter needs, and providing...
- ...Healthcare account (e.g., UM, CM, Triage, Appeals, Claims) • Knowledge of MCG/Milliman,... ...• Ability to work onsite, remote, or in hybrid training environments as required. The... ...assigned programs. REQUIREMENTS: • PHRN with ACTIVE LICENSE and 1 year CPO experience...
- ...PHRNs and USRNs! We’re hiring a "Training Specialist" to lead and develop teams in the US... ...excellence. Requirements: Active PHRN / USRN license At least 1 year of teaching... ...: Up to 60k Package (negotiable) +70k Sign on Bonus Work Set-up: Onsite/Hybrid...
- ...Job title: PHRN – Clinical Authorization Work set up: Onsite Opportunity – MCK Taguig... ...necessary information to submit an appeal of the denial. Prioritize the incoming... ...correspondence with insurance companies, physicians, specialists, and patients as needed, including...
- ...Work Setup: Willing to work full onsite during training and hybrid (3x onsite per week) upon production in Taguig Start Date: Nov 3, 2026 Requirements: ~ Pharmacy Graduates required with or without active license ~ Nursing Graduates will be considered ~1...
- ...Review and analyze clinical denial cases related to inpatient and outpatient services. Prepare and submit comprehensive appeals for denied claims to insurance providers. Collaborate with medical staff to gather necessary documentation and resolve billing issues....
- ...standards, and copyright regulations. ~ Training and Marketing Professionals, Inc. (TMPI) is looking for a (4 Headcount) Multimedia Specialists - Globe Telecommunication (Mynt Account) Requirements: ~ Bachelor’s degree in Multimedia Design, Instructional Design,...
- Qualification: Minimum of 3–5 years of experience in Physical Distribution / Supply chain processing. Import and Export Booking experience is a plus Responsibilities: Assist in ensuring an efficient filing system (hard & soft); Assist in collating required...
- ...Company: Orijin Global Brands Location: BGC, Taguig Schedule: Mon-Fri, 9am-6pm (Hybrid) Handle multiple social media accounts ensuring relevant content while keeping followers engaged Plan, create and schedule a content plan across all social media platforms...
- JOB RESPONSIBILITIES Launch UA campaigns in a systematic manner to target the right audience with the right messaging Data analyses and ad-hoc reporting that drive user acquisition, retention, and monetization for a suite of mobile app products Optimize UA campaigns...
- ...digital and sustainable transitions, creating tangible impact for both businesses and society. POSITION: Accounts Payable Specialist INDUSTRY: IT Company WORK LOCATION: Taguig WORK SCHEDULE: Night Shift SALARY: Php30,000 WORK SET UP: Work on site...
- ...purposes. They started operating in the Philippines year 2016. POSITION: Senior Audit Specialist INDUSTRY: Manufacturing Company WORK LOCATION: BGC Taguig WORK SCHEDULE: Hybrid (4 days onsite ) SALARY: Php115,000-Php120,000 WORK SET UP: Hybrid BENEFITS...
- ...most complex and challenging medical conditions. It has been established for over 77 years. Position: Project & Events Assistant (Hybrid set up) Industry: Healthcare Tech Company Work Set up: Hybrid, 2 to 3 times onsite Salary: Php 30,000 to Php 40,000...
- ...Sales & Marketing, Supply Chain, HR, and Executive Search. Job Title: French Speaking IT Service Desk Specialist Salary Range : up to P90,000 Work Setup: Hybrid Shift Schedule : Shifting Schedule Location : Taguig City The Role We are seeking a...
- ...EARN BIG AS A RISK ADJUSTMENT CODER! UP TO ₱100,000 SIGNING BONUS! PHRN + CODING LICENSE? THIS IS FOR YOU! Position: Risk Adjustment Coders (Non-Voice) Locations: Pampanga | Taguig | Cebu WHY APPLY? Salary Package: ₱35,000 – ₱45,000 ₱100,000 SIGNING BONUS...
- ...innovative technology solutions and reliable, data-driven services across multiple industries. Position: AR Collection Specialist (HYBRID SET UP) Industry: IT Company Work Location: McKinley, Taguig Salary Range: Php 20,000 – Php 40,000 Work Schedule: Shifting...
- ...Nightshift The Clinical Denials Specialist plays a vital role in ensuring accurate... ...claims, identifying denial reasons, and appealing claim denials. This role collaborates... ...Management, or a related field. Active USRN/PHRN license. Minimum of 2 years bedside...
- ...IMMEDIATELY/ASAP WILL BE PRIORITIZED Training and Marketing Professionals Inc. is looking for (1) QUALITY ASSURANCE SPECIALIST for Globe Telecom Account - Hybrid Work Set-up (Combination of On-site and Work From Home) Evaluate the output of each KYM/Onboarding...
- ...data-related processes. Position : German Bilingual Finance Specialist Location : BGC, Taguig Industry : Shared Services... ...85,000 - Php 100,000 Schedule : Flexible Work Set-Up : Hybrid (2-3 times a week onsite) JOB REQUIREMENTS: Conversation...
90000 Php
...Industry: Customer Service / Contact Center / BPO Salary: Php 90,000 Location: Taguig City Schedule: Dayshift Work Setup: Hybrid setup Benefits: ~ Visa Processing for Foreigners ~ Professional Training and Development Programs ~ HMO ~13th Month...- ...We are hiring for an Application Support Specialist for a client based in BGC. This is a Hybrid work following a Shifting schedule Salary is up to ₱130,000.00 based on experience Non -negotiable Requirements: At least 3 yrs of experience Proficient in working...
- ...Job Role: USRN Training Specialist Work Set-up: Hybrid 70k Sign on Bonus We’re hiring a "Training Specialist" to lead and develop teams in... ...sharing, this role is for you. Requirements: Active PHRN / USRN license At least 1 year of teaching experience;...
- ...Description We are seeking a skilled Hybrid Technician with knowledge of battery systems and experience in electrical and mechanical troubleshooting. The technician will be responsible for installation, inspection, maintenance, and repair of equipment and battery systems...
- ...Work Setup: Onsite Hybrid Work From Home (Account Dependent) Job Responsibilities Provide technical support to customers... ...Apply today and start your career as a Technical Support Specialist by sending your details: LAST NAME FIRST NAME CONTACT...
- Key Responsibilities 1. Requirements Analysis & Elicitation Facilitate workshops, interviews, and stakeholder discussions to gather and validate business and functional requirements. Analyze business processes, systems, and data flows. Document business requirements...
- • Implement request for ingestion, creation, and preparation of data sources • Develop and execute jobs to import data periodically/ (near) real-time from an external source • Setup a streaming data source to ingest data into the platform • Delivers data sourcing approach...
- Develop ETL jobs. Enhance an ETL job applying best practices and the spark configuration balancing. Conversion and migration of jobs from one platform to another big data platform. Integration of a job from its ingested source transforming it into various targets...
- Job Requirements: # Bachelor's Degree in Electrical Engineering, Electronics Engineering, Automation, Power Electronics, Communications, or any related field. # At least 2 years of relevant experience in: Field Application Engineering (FAE) Technical Support...
- We are seeking an experienced SAP Financial Consultant with hands-on expertise in SAP FSCM (Financial Supply Chain Management) or SAP FICO (Finance/Controlling) . The ideal candidate will have strong functional knowledge of Accounts Receivable, Accounts Payable, and...
- Work Setup: 90% Remote / 10% Onsite (BGC, Taguig – for quarterly team engagements) Internship Duration: 300 to 600 hours Work Schedule: Monday to Friday, at least 40 hours per week Compensation: Monthly Internship Allowance + Unlimited Commissions + Monthly...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to PHRN - Grievance & Appeals Specialist (Hybrid). Be the first to apply!
