PHRN - Grievance & Appeals Specialist (Hybrid)
Tasq Staffing Solutions, Inc. · Taguig, Metro Manila, Philippines · 2026-09-08
About this role
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.
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