PHRN Clinical Appeals Specialist

Registered Nurse (PHRN) | Clinical Appeals DRG Specialist | 1+ Year Clinical Appeals DRG Experience | Work From Home | ₱70K–₱85K Salary Package: ₱70,000–₱85,000 (Depending on your skills, qualifications, relevant experience, and interview results.) Work Setup: Work From Home Work Location: Quezon City | Taguig City | Cebu City Shift: Night Shift...

Recruitify_HR is seeking an experienced Registered Nurse (PHRN) with Clinical Appeals DRG expertise to join our Healthcare BPO team. Review inpatient records, evaluate documentation, and prepare appeal letters to support appropriate reimbursement.The role requires DRG experience, strong English communication, and willingness to work Night Shift; remote work...

ResponsibilitiesApply InterQual or MCG (Milliman Care Guidelines) to determine the medical necessity of requested services.Coordinate with healthcare providers to ensure clinical documentation supports the level of care.Maintain high accuracy and productivity standards in a remote, fast-paced environment.QualificationsEducation: Graduate of BS...

ResponsibilitiesApply InterQual or MCG (Milliman Care Guidelines) to determine the medical necessity of requested services.Coordinate with healthcare providers to ensure clinical documentation supports the level of care.Maintain high accuracy and productivity standards in a remote, fast-paced environment.QualificationsEducation: Graduate of BS...

Registered Nurse (PHRN) | Clinical Appeals DRG Specialist | 1+ Year Clinical Appeals DRG Experience | Work From Home | ₱70K-₱85K Salary Package: ₱70,000-₱85,000 (Depending on your skills, qualifications, relevant experience, and interview results.) Work Setup: Work From Home Work Location: Quezon City | Taguig City | Cebu City Shift: Night...

R1 RCM PHILIPPINES, INC. seeks an experienced Registered Nurse with Clinical Appeals experience to join our team. This is a full-time position where you will be responsible for crafting persuasive and accurate appeal letters at various levels of appeal. Qualifications & experience At least 2+ years of Hospital Bedside Experience. Basic Clinical Appeals...

Gratitude Philippines in Metro Manila is hiring a licensed PHRN for a full-time role. The position is night shift with onsite training; once in production, there will be 2x weekly onsite work. Start date is October 13, 2026, with a headcount of 7 and salary up to PHP 47,000 including license allowance. The role requires active RN licensing, preference for...

R1 RCM PHILIPPINES, INC. seeks an experienced Registered Nurse with Clinical Appeals experience to join our team. This is a full-time position where you will be responsible for crafting persuasive and accurate appeal letters at various levels of appeal. Qualifications & experience At least 2+ years of Hospital Bedside Experience. Basic Clinical Appeals...

NON-VOICE • ₱47,000 MAX HYBRID AFTER TRAINING A specialized back-office healthcare opportunity for experienced Registered Nurses with a background in grievance handling and case appeals. Target Start Date: October 13, 2026 Up to ₱47,000 total, including license allowance Night Shift Training: 100% Onsite Production: 2x a week onsite ...