Nurse Specialist: Denials & Appeals (IP/OP) – Night Shift

MicroSourcing; Taguig; On-site; PHP 600,000 - 900,000; Full time

Benefits offered by this job

Healthcare coverage

Sign-on bonus

Paid time-off

Life insurance

Performance bonuses

Flexible work arrangements

Job summary

MicroSourcing in Taguig is seeking a Clinical Denials & Appeals Nurse Specialist – IP & OP for an onsite night shift. You will review denied claims and manage the appeals process with payer communications, ensuring timely and accurate submissions.

Ideal candidates have 1 year of clinical appeals writing experience, 3–5 years of acute care experience, and an active RN license with US/PH credentials. EMR (Epic/Cerner/Meditech) and MS Office proficiency are required.

Qualifications

• Excellent verbal and written English communication skills.
• Strong analytical and critical thinking abilities.
• Attention to detail and follow-through.

Responsibilities

• Review denied claims and carry out the appeals process promptly.
• Submit retro-authorizations in response to denials as required by payors.
• Prepare clinical documentation summaries to accompany appeals.
• Write and submit persuasive appeals with supporting policies and timelines.
• Track status of denials and appeals and communicate with payers.

Skills

English communication

Analytical thinking

Attention to detail

Independent worker

Teamwork

Education

Bachelor of Science in Nursing

Tools

Epic EMR

Cerner EMR

Meditech EMR

Microsoft Office

Job description

MicroSourcing in Taguig is seeking a Clinical Denials & Appeals Nurse Specialist – IP & OP for an onsite night shift. You will review denied claims and manage the appeals process with payer communications, ensuring timely and accurate submissions.

Ideal candidates have 1 year of clinical appeals writing experience, 3–5 years of acute care experience, and an active RN license with US/PH credentials. EMR (Epic/Cerner/Meditech) and MS Office proficiency are required.