PHRN Appeals DRG| DRG Downcoding

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...

PHRN Appeals DRG Specialist | MUST HAVE Appeals DRG BPO Experience | Clinical Appeals Writing | WFH After Onsite Training Work Location: Quezon City / Taguig City / Cebu City Work Setup: WFH after successful completion of onsite training Training Setup: Onsite Start Date: January 2027 Openings: 31 Salary Package: ₱70,000–₱85,000 Educational...

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...

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...

Optum Philippines is seeking a seasoned nursing professional to lead clinical content development projects and support utilization review processes. You will collaborate with Clinical Leadership, physician researchers, and Medical Directors to ensure accuracy, compliance, and timely delivery of e-learning materials.The role requires deep clinical expertise,...

EPSILON GROUP SERVICES INC. is seeking a PAS Appeals DRG specialist focused on clinical appeals writing. You will review clinical documentation and craft appeal letters for denials, using DRG and coding guidelines to support approvals.The role begins with onsite training in Quezon City / Taguig City / Cebu City, then work-from-home flexibility. Hours are...

Private Advertiser is seeking an Inpatient DRG Coder to join our IP DRG team. You will determine if discrepancies exist in coding and clinical documentation using standard guidelines.Responsibilities include conducting initial audit reviews, recording results, handling provider appeals, reviewing complex cases, and proposing audit concepts with analytics...

Optum Philippines is seeking a seasoned nursing professional to lead clinical content development projects and support utilization review processes. You will collaborate with Clinical Leadership, physician researchers, and Medical Directors to ensure accuracy, compliance, and timely delivery of e-learning materials. The role requires deep clinical expertise,...

Work setup: On-site (Initially will be assigned to BGC, Taguig, and will then be transferred to Bridgetown, QC within 6 months) REQUIRED QUALIFICATIONS: Must be an active PHRN Must hold an active coding certification (at least one of the following): CCS, CPC, CIC; CDAS preferred Must have experience in Inpatient (IP) DRG Coding, Inpatient Surgery Coding,...