Appeals Coder/CV Nurse - Hybrid, Critical Care Coding

Optum, a UnitedHealth Group Company; Metro Manila; Hybrid; PHP 420,000 - 720,000; Full time

Benefits offered by this job

Fixed weekends off

Health plan (HMO) from day 1

Retirement plan

Medical plan

Job summary

Optum Philippines is seeking an Appeals Coder/CV Nurse to review patient records, extract case details, and craft defensible appeal letters according to process instructions and guidance.

The role requires active PHRN and Medical Coding licenses, plus strong clinical knowledge with 3+ years in critical care. A minimum of 2 years in medical coding is expected. Hybrid work is available across Makati, Alabang, and Quezon City.

Qualifications

• Critical Care bedside experience (3+ years) in a tertiary hospital or equivalent setting.
• At least 2 years of Medical Coding experience.
• Active PHRN license and Medical Coding license (AAPC or AHIMA)

Responsibilities

• Review and extract pertinent case details from patient medical records.
• Craft defensible appeal letters per process instructions and guidance.
• Adhere to Optum and OPAS policies and procedures.
• Complete cases within time expectations while maintaining high-quality reviews.

Skills

Critical Care experience

Medical coding experience

Education

PHRN License and Medical Coding License (AAPC/AHIMA)

Job description

Optum Philippines is seeking an Appeals Coder/CV Nurse to review patient records, extract case details, and craft defensible appeal letters according to process instructions and guidance.

The role requires active PHRN and Medical Coding licenses, plus strong clinical knowledge with 3+ years in critical care. A minimum of 2 years in medical coding is expected. Hybrid work is available across Makati, Alabang, and Quezon City.