Senior Health Appeals Analyst RN | Grievances & UM

Accenture in the Philippines

Taguig

On-site

PHP 600,000 - 800,000

Full time

3 days ago

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Job summary

Accenture in the Philippines is seeking a Health Clinical Services Senior Analyst in Taguig for night shift. You will create appeal records for external reviews, draft detailed case summaries, and submit cases to regional teams as directed.

Ideal candidates hold a US RN license and a BSN or equivalent nursing degree, with at least 3 months of clinical experience. Appeals experience is a plus, and the role is based in Uptown Bonifacio Tower, Taguig.

Qualifications

Active RN license and direct patient care experience.
Nursing degree or diploma (BSN/GNM/BSc/Associate/Bachelor) required.
Clinical background in inpatient, outpatient, or community settings.

Responsibilities

Create complete appeal records for external review using standardized forms.
Develop detailed narrative case summaries for each appeal.
Submit cases to respective geographic region as directed.
Present verbal and written case summaries to Grievance Team and Medical Directors.
Meet client turnaround times for assignments.