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MEDICAL CODERS WITH SOB (HCC, IP, OP, RA)

MEDICAL CODERS WITH SOB (HCC, IP, OP, RA)

HRTXTaguig, Philippines
18 days ago
Job description
  • Review and analyze medical records to assign accurate codes (ICD-10-CM, CPT, HCPCS) based on documentation.
  • Ensure coding quality and accuracy in accordance with official coding guidelines, payer policies, and organizational standards.
  • Validate documentation for Risk Adjustment (RA) models, including HCC coding , by identifying and capturing chronic conditions and relevant diagnoses. OR Perform coding for Inpatient and Outpatient encounters, ensuring all procedures and diagnoses are correctly captured.
  • Query providers for clarifications when documentation is incomplete or ambiguous.
  • Collaborate with clinical and billing teams to resolve coding and documentation discrepancies.
  • Maintain coding productivity and quality standards as defined by management.
  • Stay current with industry regulations, coding updates, and best practices.
  • Assist with internal and external coding audits and implement corrective actions, if needed.
  • Protect patient confidentiality and follow HIPAA guidelines at all times.
  • Qualifications :

    • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Risk Adjustment Coder (CRC), or equivalent credential preferred.
    • Minimum 12 years of experience in medical coding, specifically in HCC, IP, OP, or RA settings.
    • Strong knowledge of medical terminology, anatomy, physiology, and disease processes.
    • Experience using Electronic Health Records (EHR) and coding software.
    • Detail-oriented with strong analytical, communication, and organizational skills.
    • Ability to work independently and meet strict deadlines.
    • Must be willing to report on site in Taguig or Cubao (Wherever your nearest / Preferred location)
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    Medical Coder • Taguig, Philippines