PHRN - Grievance & Appeals Specialist (Hybrid)

Tasq Work; Taguig; On-site; PHP 240,000 - 360,000; Full time

Job summary

Tasq Work in the Philippines is seeking a licensed PHRN to join our on-site healthcare operations team in Taguig. The role focuses on clinical review, documentation, claims processing, utilization management, and case management, with start date Oct 13, 2026.

Work setup starts full onsite, with production requiring 2x onsite visits per week; night shift schedule applies. This is a physician-adjacent clinical review and claims support role for an experienced RN.

Qualifications

• PHRN with Active license.
• At least 1 year grievance & case appeals experience.
• Back-office (Non-voice) experience preferred.

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.

Skills

Active PHRN license

Grievance & case appeals

Back-office

Job description

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.