Clinical Coding Auditor (RN) – Outpatient & Specialty

Cotiviti Philippines Inc; Manila; On-site; PHP 600,000 - 800,000; Full time

Job summary

Cotiviti Philippines Inc in Manila seeks a registered nurse auditor to focus on coding and clinical chart validation for outpatient and specialty audits.

The role emphasizes auditing outpatient/specialty claims, adherence to coding guidelines, medical necessity, and appropriate service settings. Requires CPC/COC/CIC/CCS certification, US healthcare experience, and strong communication with high accuracy.

Qualifications

• RN with CPC/COC/CIC/CCS certification and US healthcare auditing experience.
• Experience in coding, medical billing, and RCM operations preferred.
• Strong written and verbal communication; high accuracy.

Responsibilities

• Audits Outpatient and Specialty Claims.
• Uses client-specific guidelines to support medical audits.
• Reviews medical records and applies coding principles to identify issues.
• Maintains quality and productivity standards.

Skills

Medical coding

Auditing

Healthcare knowledge

Communication skills

Education

Registered Nurse

CPC/COC/CIC/CCS certification

Tools

Cotiviti encoder

Audit software

Job description

Cotiviti Philippines Inc in Manila seeks a registered nurse auditor to focus on coding and clinical chart validation for outpatient and specialty audits.

The role emphasizes auditing outpatient/specialty claims, adherence to coding guidelines, medical necessity, and appropriate service settings. Requires CPC/COC/CIC/CCS certification, US healthcare experience, and strong communication with high accuracy.