Appeals DRG Specialist | DRG Appeals & Downcoding Experience Required | Work From Home | Up to ₱80K

WE'RE HIRING – PAS Appeals DRG Specialist | DRG Appeals & Downcoding Experience Required | Work From Home | Up to ₱80K

Location: Quezon City | Taguig City | Cebu Work Setup: Work From Home Shift: Night Shift Salary Package: ₱64,000–₱80,000 Start Date: September 24, 2026

Job Overview

We're looking for experienced PHRN PAS Appeals DRG Specialists with a strong background in Clinical Appeals Writing, DRG Appeals, and DRG Downcoding. If you have experience preparing successful appeal letters and working with medical necessity denials, this is an excellent opportunity to work from home while advancing your healthcare career.

Qualifications

Active PHRN License

College Graduate – BS Nursing

At least 6 months to 1+ year of Clinical Appeals Writing experience

Hands-on experience in DRG Appeals and DRG Downcoding is required

Experience writing appeals for:

Medical Necessity Denials

Authorization Denials

DRG Downgrades

Readmission Cases

Familiar with MCG, InterQual, and ICD-10 Coding Guidelines

Experience using SOFA, KDIGO, GLIMS, and ASPEN criteria

Experience in Medical Coding, Clinical Documentation Improvement (CDI), or DRG Validation/Downcoding

Experience with MS-DRG and APR-DRG is highly preferred

Strong clinical writing, critical thinking, and analytical skills

Excellent English communication skills

Willing to work on a Night Shift

Can start September 24, 2026

Pay: Php65,000.00 - Php85,000.00 per month

Benefits:

Paid training

Work Location: Remote