PHRN – Grievance & Case Appeals Specialist
Job Description
Key Skills
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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.
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?
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