PHRN Appeals DRG | DRG Downcoding & Coding Appeals Exp | WFH After Training

PHRN Appeals DRG | DRG Downcoding & Coding Appeals Experience | WFH After Training | Up to ₱80K

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 ₱80,000, depending on your recruitment process experience Start Date: October 8, 2026 Openings: 8

About the Role

The PHRN Appeals DRG Specialist will review clinical documentation and prepare appeal letters for DRG downcoding and coding-related appeals. The role requires strong clinical review and appeal writing skills, with the ability to support appeals using appropriate clinical and coding guidelines.

Qualifications

• Active PHRN License
• Bachelor’s Degree in Nursing
• 6 months to 1+ year Clinical Appeals Writing experience
• Experience with DRG Downcoding and 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 is preferred
• Experience writing appeals for Medical Necessity Denials, Authorization Denials, DRG Downgrades, and Readmission cases