Medical Appeals Specialist (PHRN) – Work From Home

We're Hiring | Medical Appeals Specialist (PHRN)

Join our healthcare team and help improve reimbursement outcomes by preparing high-quality clinical appeals.

What You'll Do

  • Prepare appeal letters for denied healthcare claims
  • Review clinical documentation and medical records
  • Handle medical necessity, authorization, DRG downgrade, and readmission appeals
  • Apply ICD-10, MCG, and InterQual guidelines
  • Ensure appeals comply with payer requirements

Qualifications

  • Registered PHRN
  • 6 months–1 year of Clinical Appeals Writing experience
  • Experience with DRG downcode/coding appeals
  • Knowledge of MCG/InterQual and ICD-10 guidelines
  • Medical Coding, CDI, or DRG downcode experience
  • MS-DRG experience required (APR-DRG is a plus)

Location: Quezon City | BGC | Taguig | Cebu
Work Setup: Work From Home
Shift: Day to Mid Shift

Interested? Apply now or send your updated CV!

Pay: Php60,000.00 - Php79,000.00 per month

Application Question(s):

  • • Bachelor's degree:
  • Are you a PHRN?
  • Year of experience in Clinical Appeals Writing?
  • Are you familiar with DRG downcode or coding appeals?
  • Are you familiar with use of MCG/InterQual guidelines/ICD-10 coding guidelines?
  • Are you willing to work remotely?
  • Are you amenable to work day shift-mid shift schedule?
  • Current Salary:
  • Expected Salary:
  • Notice Period:
  • Reason for leaving your current/previous job:
  • Active email:
  • Active Viber:
  • Complete Address:
  • Full name (First name, Middle Name, Last Name)

Work Location: Remote

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