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Open nowFirst seen 35 hours ago

Appeals Coder

PM Consulting1,469 open roles

Where
Makati City, Metro Manila, Philippines
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Your applicationOpen nowAppeals CoderPM Consulting · Makati City, Metro Manila, Philippines

  1. YouYes, apply to this one.

  2. CV RocketCV written for this posting.

  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

  4. CV RocketApplied on PM Consulting's own form.

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The clock on this job

Early applications get read.

11.5% of postings close within 7 days. Measured by our own scanner across the market. PM Consulting postings stay open a median of 1 days.

Share of postings closed within
  1. 2.0%1 day
  2. 4.3%3 days
  3. 11.5%7 days
  4. 18.1%14 days
  5. 35.6%30 days
  6. 44.6%60 days
This job: first seen 35 hours ago

PM Consulting median: 1 days open

The posting

OPAS Appeals Coder / Cardiovascular Nurse

Location: Quezon City, Makati, or Muntinlupa

Work Setup: Hybrid

Schedule: Shifting Schedule

Job Summary

The OPAS Appeals Coder / Cardiovascular Nurse is responsible for reviewing and extracting pertinent clinical information from patient medical records and preparing well-supported appeal letters based on established guidelines and process requirements. This role requires strong clinical and coding expertise to ensure accurate, high-quality case reviews while meeting productivity and turnaround time expectations.

Key Responsibilities

  • Review patient medical records and identify relevant clinical information for appeals processing.
  • Accurately extract and document case details based on established guidelines.
  • Prepare clear, concise, and defensible appeal letters supported by clinical documentation and coding standards.
  • Ensure all cases are completed within established productivity and quality targets.
  • Maintain compliance with company policies, client requirements, and regulatory standards.
  • Collaborate with internal teams to resolve case-related concerns and ensure accurate outcomes.
  • Apply clinical knowledge and coding expertise to support appeal decisions and documentation reviews.

Qualifications

  • Bachelor's Degree in Nursing.
  • Active Philippine Registered Nurse (PHRN) License.
  • Active Coding Certification such as: CCS CCS-P CPC-H CPC RHIT RHIA CDIP CCDS
  • At least 3 years of recent clinical bedside experience within the last 5 years in a tertiary or secondary hospital setting, preferably in: ICU CCU Telemetry Cardiovascular ICU Medical ICU Emergency Room (ER) Medical-Surgical Unit (MS)
  • Minimum of 2 years of medical coding experience.
  • Strong attention to detail, analytical skills, and clinical judgment.
  • Excellent written and verbal communication skills.
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