{"id":2154580,"url":"https://alion.io/job/med-metrix-appeal-writer","title":"Appeal Writer","company":{"id":3787069,"name":"Med-Metrix","domain":"med-metrix.com","url":"https://alion.io/company/med-metrix","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Dayforce","truth_index":{"grade":"B","score":80,"open_postings":24,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":9,"computed_at":"2026-10-26T05:57:25Z"}},"role":"Communications","role_family":"Communications","seniority":"junior","employment_type":null,"work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Pasig, Philippines"],"countries":["PH"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":8000,"max_usd":16000,"period":"year","method":"global_role_cell_scaled_by_country","sample_n":527},"experience_years_min":1,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-01-01T16:00:00Z","employer_posted_date":"2026-10-09","last_verified_at":"2026-10-26T22:05:21Z","board_verified":true,"closed_at":null,"days_open":298,"trust":{"level":"stale","repost_count":0,"flags":["stale"],"days_open":297},"description":"Experience these exceptional benefits when you join Med-Metrix!\n8-Hour Shifts, Fixed Weekends Off\nDay 1 HMO with 2 of your dependents covered for FREE\nGroup Life Insurance\nMedical Cash Allowance\nRice Allowance\nClothing Allowance\nHoliday Gift\nBereavement Assistance\nFree Lunch Daily\nPaid Time Off\nTraining and Staff Development\nEmployee Engagement Activities\nOpportunities for Internal Mobility\nThe Appeals Writer supports the Company by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Appeal Writer creates appeal letters in support of claim payment.\nDuties and Responsibilities\nReview and analyze appeals and grievances to determine appropriate resolutions\nEnsure compliance with CMS (Centers for Medicare & Medicaid Services) regulations and guidelines, and client specific rules\nConduct thorough investigations, including gathering and reviewing medical records, provider documentation, and member information\nPrepare detailed case summaries and decision letters\nCommunicate effectively with members, providers, and regulatory agencies to resolve issues\nMaintain accurate and up-to-date records of all appeals and grievances\nIdentify trends and provide recommendations for process improvements\nCollaborate with internal departments to ensure timely and accurate resolution of cases\nAbility to work in a fast paced and production environment\nReview denied insurance claims\nReview patients’ medical files\nDevelop strategies to reverse claim denials\nCreate written appeals\nManage and organize appeal workflow based on internal, client-based, and insurance-driven deadlines\nUse, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards\nQualifications\nMust be a Registered Nurse. 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