PHRN Appeals DRG| DRG Downcoding & Coding Appeals Exp up to 80k

EPSILON GROUP SERVICES INC.; Metro Manila; Hybrid; PHP 812,000 - 973,000; Full time

Job summary

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 8:00 AM–5:00 PM. Salary up to ₱80,000, with 8 openings and a start date of October 8, 2026.

Qualifications

• Active PHRN license
• BS Nursing degree
• 6 months to 1+ year clinical appeals writing experience
• Experience with DRG downcoding or coding appeals
• Experience using MCG / InterQual guidelines
• Experience with ICD-10 coding guidelines
• Experience using SOFA, KDIGO, GLIMS, and ASPEN criteria
• Medical Coding, CDI, or DRG Downcode experience
• Experience with MS-DRG and APR-DRG preferred
• Experience writing appeals for Medical Necessity Denials, Authorization Denials, DRG Downgrades, and Readmission cases

Skills

Clinical writing

DRG coding appeals

Medical coding

ICD-10 guidelines

Education

BS Nursing

Tools

MCG guidelines

InterQual guidelines

ASPEN criteria

Job description

PAS Appeals DRG | Clinical Appeals Writing Experience | DRG Downcoding / Coding Appeals | WFH After Training | Up to ₱60K

Work Location: Quezon City / Taguig City / Cebu City
Work Setup: Onsite Training, then Work From Home
Shift: 8:00 AM–5:00 PM
Salary: up to 80k
Start Date: October 8, 2026
Openings: 8

About the Role

The role focuses on clinical appeals writing, including reviewing clinical documentation and composing appeal letters for different types of healthcare denials. Candidates will use clinical and coding guidelines to support appeals and help secure appropriate claim approvals.

Qualifications

• Active PHRN License

• College Graduate of BS Nursing

• 6 months to 1+ year Clinical Appeals Writing experience

• Experience with DRG downcoding or coding appeals

• Experience using MCG / InterQual guidelines

• Experience with ICD-10 coding guidelines

• Experience using SOFA, KDIGO, GLIMS, and ASPEN criteria

• Medical Coding, CDI, or DRG Downcode experience

• Experience with MS-DRG and APR-DRG preferred

• Experience writing appeals for Medical Necessity Denials, Authorization Denials, DRG Downgrades, and Readmission cases