PHRN – Grievance & Case Appeals Specialist

Gratitude Inc

63 Views

5 days ago

PHRN – Grievance & Case Appeals Specialist

1-10 Year(s)

₱ 45 - ₱ 47K p.m

Manila

Quick Apply Apply

Job Description

Key Skills

Back office PHRN Grievances Support Experience

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

WORK SETUP: Full Onsite during Training; 2x per week Onsite once in Production

WORK SHIFT: Night Shift

SALARY: ₱47,000 Max (including license allowance)

TARGET START DATE: October 13, 2026

Role Overview

We are seeking an active PHRN (Philippine Registered Nurse) to join our team as a Grievance & Case Appeals Specialist. This is a back-office (non-voice) role responsible for reviewing and resolving grievance and case appeals. You will leverage your clinical expertise to assess cases, ensure compliance with guidelines, and support timely resolution.

Key Responsibilities

Review and process grievance and case appeals

Assess clinical documentation and medical necessity

Ensure compliance with regulatory and client guidelines

Collaborate with internal teams to resolve complex cases

Document findings and determinations accurately

Meet quality, productivity, and turnaround time targets

Qualifications

PHRN with active license – required

Active Registered Nurse – required

Must have at least 1 year of grievance & case appeals experience – required

Back-office (non-voice) – required

Willing to work on night shift schedule and attend training onsite; once in production, 2x a week onsite – required

Job hoppers who change jobs frequently in less than a year should be rejected

Why Join?

Competitive salary: ₱47,000 Max (including license allowance)

Hybrid work setup after training

Career growth in healthcare appeals and utilization management

Night shift schedule

Role

Philippines Registered Nurse

Timings

Night Shift (Permanent)

Industry

BPO

Work Mode

Hybrid

Process

Non-Voice

Functional Area

ITES / BPO / Customer Service

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.

Jecinta Kariuki

Recruiter - Gratitude Inc

NA, kenya

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