Job Title: Medicare Grievance Specialist (Pharma Technicians)

Shift: Night shift

Work Set-up: On-site in  Bridgetowne, Quezon City

Salary range: 40K package

Target  Start Date: December 16, 2025

QUALIFICATIONS:

Education and Certifications: 

• Medical Allied Health graduate required (licensed/non-licensed) 

• Strong pharmacovigilance/ drug safety review experience (preferred but not required) 

Experience: 

• Minimum 1 year of experience in a healthcare contact setting work experience (e.g., 

pharmacy technician, claims processor, provider services) 

• Experience handling grievances or healthcare-related customer support in a 

contact center setting 

Other Requirements: 

• Understanding of HIPAA and other healthcare regulations. 

• Willingness to work flexible schedules, including UShours 

Recommended Minimum Skills Requirements (MSRs):

1. Technical Skills: 

• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) 

2. Soft Skills: 

• Strong problem-solving and decision-making abilities 

• Excellent verbal and written communication skills in English 

• High level of empathy, patience, and active listening 

3. Operational and Communication Skills: 

• Ability to prioritize tasks and meet deadlines in a fast-paced environment 

• Strong organizational and documentation skills 

• Accuracy and attention to detail 

• Ability to communicate effectively and convey complex information

KEY RESPONSIBILITIES:

1. Grievance Handling: 

o Investigate and resolve member grievances related to Medicare Part D drug 

coverage, claims, and pharmacy issues 

o Ensure all grievances are resolved within required CMS timelines and documented 

appropriately 

2. Communication: 

o Act as a liaison between members, providers, and pharmacies for Medicare 

grievance resolution 

o Provide clear and empathetic communication throughout the grievance process 

3. Compliance: 

o Adhere to all CMS (Centers for Medicare & Medicaid Services) guidelines and 

company policies 

o Maintain confidentiality of sensitive member information 

4. Documentation: 

o Accurately document all interactions and resolutions in the client system 

o Prepare reports as required for compliance and auditing purposes 

5. Collaboration: 

o Work closely with other departments to investigate and resolve grievances 

o Provide insights and feedback on recurring issues to improve processes 

Recommended Minimum Skills Requirements (MSRs) 

PRE-SCREENING QUESTIONS:

1. Are you a Medical Allied Health graduate?

2. How many years of work experience do you have in a healthcare contact setting (e.g., 

pharmacy technician, claims processor, provider services)?

3. How many years of experience do you have in handling grievances or healthcare-related customer support in a contact center/BPO setting?

4. Do you have a strong pharmacovigilance/ drug safety review experience

5. Do you have an understanding of HIPAA and other healthcare regulations? 

6. How much is your last drawn salary?

7. How much is your salary expectation?

8. Are you amenable to working onsite in Bridgetowne, Quezon City, with a night shift and fixed weekends off schedule?

9. This is an urgent hiring. Are you able to start on or before December 16?