Certified Medical Coder (PHRN + CPC-A ) | Day 1 HMO!

Hammerjack Pty Ltd; Metro Manila; Hybrid; PHP 480,000 - 720,000; Full time

Benefits offered by this job

Fixed Weekends Off

Pure Non-Voice Account

Medical Plan (HMO) from Day 1 of work

Retirement Plan

Dental, Medical, and Optical Reimburse

Life and Disability Insurance

Paid Time-Off Benefits

Tuition Fee Reimbursement

EAP

Annual Merit Increases

Employee Recognition

Training and Staff Development

Employee Referral Program

Volunteerism Opportunity

All Mandatory Statutory Benefits

Job summary

Optum is seeking an Appeals Coder/CV Nurse to review patient medical records, extract key case details, and draft defensible appeal letters under process guidance. The role emphasizes timely case completion and high-quality reviews in alignment with Optum and OPAS policies.

The position offers a hybrid setup across Manila sites with competitive compensation and benefit programs. The ideal candidate has active PHRN and coding licenses plus clinical and coding experience.

Qualifications

• Active PHRN license and Medical Coding license required.
• 3+ years of critical care bedside experience in a tertiary hospital.
• 2+ years of medical coding experience required.

Responsibilities

• Review and extract pertinent case details from patient medical records.
• Craft strongly defensible appeal letters per process instructions and company guidance.

Skills

Medical Coding Experience

Education

Active PHRN License and Medical Coding License (AAPC or AHIMA)

Job description

ROLE AND RESPONSIBILITIES

• The Appeals Coder/CV Nurse will accurately and efficiently review and extract pertinent case details from patient medical records; and craft strongly defensible appeal letters per process instructions and the department's/company's guidance.
• The Appeals Coder/CV Nurse will complete their case within the time expectations while providing high quality reviews. The Appeals nurse will perform their job functions, adhering to both Optum and OPAS policies and procedure.

Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life's best work.

JOB QUALIFICATIONS

• Active PHRN License and Medical Coding License (AAPC or AHIMA)
• Strong Clinical Knowledge base with a minimum of 3 years of Critical Care bedside experience in a tertiary hospital (local/overseas), (areas: ICU, Critical Care Unit, Telemetry, Cardiovascular Intensive Care Unit, Medical Intensive Care Unit, ER, Medical Surgical)
• At least 2 years of Medical Coding experience
• Willing to work on a hybrid set-up in any of our sites (Makati, Alabang, Quezon City)

WHAT WE OFFER

• Fixed Weekends Off
• Pure Non-Voice Account
• Market Competitive Pay Levels
• Retirement Plan
• Medical Plan (HMO) from Day 1 of employment
• Dental, Medical, and Optical Reimbursements
• Life and Disability Insurance
• Paid Time-Off Benefits
• Sick Leave Conversion
• Tuition Fee Reimbursement
• Employee Assistance Program (EAP)
• Annual Performance Based Merit Increases
• Employee Recognition
• Training and Staff Development
• Employee Referral Program
• Employee Volunteerism Opportunity
• All Mandatory Statutory Benefits

WHO WE ARE

• Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
• UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
• We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
• As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
• Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to Caring. Connecting. Growing together