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

Optum, a UnitedHealth Group Company; Metro Manila; Hybrid; PHP 350,000 - 600,000; Full time

Benefits offered by this job

Fixed Weekends Off

Pure Non-Voice Account

Market Competitive Pay Levels

Retirement Plan

Medical Plan (HMO) from Day 1

Dental, Medical, and Optical Reimburse

Life and Disability Insurance

Paid Time-Off Benefits

Sick Leave Conversion

Tuition Fee Reimbursement

Employee Assistance Program (EAP)

Annual Merit Increases

Employee Recognition

Training and Staff Development

Employee Referral Program

Employee Volunteerism Opportunity

All Mandatory Statutory Benefits

Job summary

Optum in the Philippines seeks an Appeals Coder/CV Nurse to review medical records, extract case details, and craft defensible appeal letters per process instructions and company guidance.

Role demands timely, high-quality reviews and adherence to Optum and OPAS policies. Hybrid work is available at Makati, Alabang, or Quezon City, supporting member and provider care efforts.

Qualifications

• Active PHRN license and medical coding license (AAPC or AHIMA CPC-A/CPC/CCS/CIC/COC) required.
• Minimum 3 years of critical care bedside experience in a tertiary hospital (local/overseas).
• At least 2 years of medical coding experience.
• Willing to work in a hybrid setup at Makati, Alabang, or Quezon City.

Responsibilities

• Review and extract pertinent case details from patient medical records and craft defensible appeal letters according to process instructions and company guidance.
• Complete cases within time expectations while providing high quality reviews, adhering to Optum and OPAS policies and procedures.

Skills

Clinical Knowledge

Medical Coding

Education

Active PHRN License

Medical Coding License (AAPC/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 (CPC-A, CPC, CCS, CIC, COC)




• 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