ACCPRO INTERNATIONAL
Job Description PAS Appeals (DRG) Job Responsibilities: Appeal Letter Writing: Proven experience in composing appeal letters for various levels of appeals, showcasing a high success rate in securing approvals. Compliance: Familiarity with healthcare laws, regulations, medical care guidelines (MCG or InterQual) and insurance policies related to appeals and medical necessity criteria. Experience in writing appeals for different denial types including Medical Necessity Denials, Authorization Denials, DRG downgrades, and readmission cases. Qualifications 6 months to 1 yr+ Clinical Appeals Writing Experience Familiar with use of MCG / InterQual guidelines / ICD-10 coding guidelines Medical Coding, CDI, or DRG downcode experience SOFA and KDIGO criteria experience Experience with MS-DRG (Medicare Severity; the more common DRG) and APR-DRG (All Patients Refined; the less common DRG) is preferred Must be a BS Nursing or Med Allied course Active PHRN license Work Arrangements Work Location: Cebu, QC & Taguig Work Setup: WFH Start date: August 20, 2026 Benefits OFFERED: Competitive Total Rewards Package Target variable incentives Medical Plan (HMO) from Day 1 of employment with free dependents Life insurance Paid Time-Off Benefits Sick Leave Conversion Night Differential offered Employee Referral Program All Mandatory Statutory Benefits Pay: Php64,000.00 - Php80,000.00 per month Application Question(s): Years of experience in Clinical Appeals Writing: Are you a PHRN Are you familiar with DRG downcoding or coding appeals? Are you familiar with MCG/InterQual guidelines and ICD-10 coding guidelines? Work Location: Remote
ACCPRO INTERNATIONAL
