Inpatient Appeals Coder — Hybrid (CPC/CCS)

Optum, a UnitedHealth Group Company; Metro Manila; Hybrid; PHP 400,000 - 640,000; Full time

Benefits offered by this job

Fixed Weekend Off

Non-Voice Account

Medical Plan (HMO) from Day 1

Dental, Medical, and Optical Reimburse

Life and Disability Insurance

Paid Time-Off Benefits

Tuition Fee Reimbursement

Employee Assistance Program (EAP)

Job summary

Optum, a UnitedHealth Group Company, is seeking an Appeals Coder/CV Nurse to accurately review medical records and craft defensible appeal letters. The role requires experience in medical coding and familiarity with appeals, utilization management, or denial management.

Hybrid work arrangements are available across Makati, Alabang, and Quezon City. The position offers a comprehensive benefits package including health coverage, retirement plans, and paid time off, among others.

Qualifications

• Must be a Medical Allied graduate with active license.
• Active medical coding certification such as CPC, CCS, COC, CIC, or CRC.
• At least 3 years of medical coding experience; inpatient coding experience preferred.
• Experience in clinical appeals, utilization management, or denial management is an advantage.
• Willing to work on a hybrid set-up in Makati, Alabang, or Quezon City sites.

Responsibilities

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

Skills

Medical coding

Clinical appeals

Utilization management

Denial management

Education

Active medical license

Medical coding certification (CPC, CCS, COC, CIC, CRC)

Job description

Optum, a UnitedHealth Group Company, is seeking an Appeals Coder/CV Nurse to accurately review medical records and craft defensible appeal letters. The role requires experience in medical coding and familiarity with appeals, utilization management, or denial management.

Hybrid work arrangements are available across Makati, Alabang, and Quezon City. The position offers a comprehensive benefits package including health coverage, retirement plans, and paid time off, among others.