Certified Medical Coder – Registered Nurse
Job Description
We are seeking a detail-oriented and highly skilled Certified Medical Coder – Registered Nurse to join our team. In this role, you will be responsible for reviewing complex medical records, extracting critical clinical information, and preparing well-supported appeal documentation. This position offers an opportunity to combine clinical expertise with coding proficiency in a dynamic, quality-driven environment.
Duties and Responsibilities
Review and analyze patient medical records to extract accurate and relevant clinical information
Prepare comprehensive and defensible appeal letters in accordance with established guidelines and protocols
Ensure timely completion of assigned cases while maintaining high standards of quality and accuracy
Apply clinical knowledge and coding expertise to support appropriate case evaluation and decision-making
Adhere strictly to Optum and OPAS policies, procedures, and compliance requirements
Maintain confidentiality and integrity of patient data at all times
Contribute to continuous quality improvement and operational excellence
Collaborate with internal teams to ensure consistency and effectiveness in case handling
Requirements
Active PHRN License and Medical Coding Certification (AAPC or AHIMA)
Minimum 3 years of clinical experience in critical care settings within a tertiary hospital (e.g., ICU, CCU, CVICU, MICU, ER, Telemetry, Medical-Surgical)
At least 2 years of experience in medical coding
Strong clinical judgment, analytical skills, and attention to detail
Ability to work efficiently within defined timelines
Willingness to work in a hybrid setup (Makati, Alabang, or Quezon City)
What We Offer
Fixed weekends off and a pure non-voice account
Competitive salary and performance-based incentives
Comprehensive HMO coverage from Day 1
Dental, medical, and optical reimbursements
Life and disability insurance
Paid time-off benefits and sick leave conversion
Retirement plan and statutory benefits
Tuition fee reimbursement and continuous learning opportunities
Employee Assistance Program (EAP)
Career growth, recognition programs, and referral incentives
Opportunities for employee engagement and volunteerism
About Optum
Optum, part of the UnitedHealth Group, is a global leader in healthcare technology and services. With a mission to help people live healthier lives and improve healthcare systems, Optum supports over 125 million individuals worldwide.
Join a diverse and innovative organization dedicated to transforming healthcare through technology, expertise, and compassion.
