Onsite Night Shift: Clinical Denials & Appeals Nurse

MicroSourcing International; Taguig; On-site; PHP 400,000 - 700,000; Full time

Benefits offered by this job

Healthcare coverage day one

Paid time-off with cash conversion

Performance bonuses

Flexible work arrangements

Job summary

MicroSourcing is hiring a Clinical Denials & Appeals Nurse Specialist – IP & OP in Taguig. The role focuses on reviewing denied claims and guiding the appeals process efficiently. Strong clinical background and payor policy understanding are essential.

The candidate will communicate with payers and internal teams, perform medical necessity reviews, and document outcomes to support timely reimbursements. Night-shift onsite position with competitive benefits.

Qualifications

• Nurse with BSN and RN license
• 3–5 years of acute care clinical experience
• Experience with denials, appeals, or revenue cycle management preferred
• Proficient with EMR systems (Epic, Cerner, Meditech)
• Excellent English communication, both written and spoken

Responsibilities

• Review denied claims and manage the appeals process promptly
• Submit retro-authorizations in line with payor requirements
• Conduct medical necessity reviews and prepare documentation
• Draft persuasive appeals with supporting clinical and policy references
• Document actions and follow up with payers and internal teams
• Track status of denials and appeals and report trends

Job description

MicroSourcing is hiring a Clinical Denials & Appeals Nurse Specialist – IP & OP in Taguig. The role focuses on reviewing denied claims and guiding the appeals process efficiently. Strong clinical background and payor policy understanding are essential.

The candidate will communicate with payers and internal teams, perform medical necessity reviews, and document outcomes to support timely reimbursements. Night-shift onsite position with competitive benefits.