Remote Clinical Appeals Specialist: DRG & Coding Expert

PM Consulting; Metro Manila; On-site; PHP 3,708,282 - 4,944,376; Full time

Job summary

PM Consulting is seeking a Clinical Appeals Specialist to review and prepare appeals for denied healthcare claims. The role requires analyzing medical documentation and applying coding guidelines to support medical necessity.

The ideal candidate should have experience in clinical appeals writing and coding within the US healthcare environment, along with strong analytical and communication skills. This position allows for remote work.

Qualifications

• At least 6 months to 1+ year of Clinical Appeals Writing experience.
• Experience handling DRG downgrade appeals or coding appeals preferred.
• Strong understanding of ICD-10 coding guidelines.

Responsibilities

• Review denied healthcare claims and prepare appeal documentation.
• Analyze medical records to support medical necessity and coding accuracy.
• Prepare clear clinical appeal letters.

Skills

Clinical Appeals Writing

ICD-10 Coding

Critical Thinking

Analytical Skills

Written Communication

Job description

PM Consulting is seeking a Clinical Appeals Specialist to review and prepare appeals for denied healthcare claims. The role requires analyzing medical documentation and applying coding guidelines to support medical necessity.

The ideal candidate should have experience in clinical appeals writing and coding within the US healthcare environment, along with strong analytical and communication skills. This position allows for remote work.