Coding & Denial Auditor – Revenue Cycle

Health Business Solutions LLC; Manila; On-site; PHP 2,457,002 - 3,685,503; Full time

Job summary

Health Business Solutions LLC is actively seeking a Coding and Denial Auditor in Manila. This role involves auditing hospital claims, identifying coding issues, and reviewing denial situations. Candidates should have 2 or more years of hospital coding or denial auditing experience, with certifications like CCS or CPC preferred.

Experience in clinical settings can enhance your candidacy. Join our team to support revenue integrity initiatives and drive denial prevention efforts!

Qualifications

• 2+ years of hospital coding or denial auditing experience required.
• Revenue cycle expertise and knowledge of CMS and commercial payers necessary.
• Clinical experience preferred for supporting medical necessity.

Responsibilities

• Audit hospital inpatient and outpatient coding.
• Review claim denials and underpayments.
• Identify coding and documentation issues.
• Support revenue integrity and denial reduction efforts.
• Provide feedback and education to coding teams.

Skills

Hospital coding experience

Denial auditing experience

Knowledge of ICD-10-CM/PCS

Payer guideline knowledge

Clinical background

Education

Active credential: CCS, CPC, CIC, or CCS-P

Job description

Clinical Experience Preferred

Now Hiring a Coding and Denial Auditor!

We’re seeking an experienced Coding Auditor / Denial Auditor to support hospital revenue cycle auditing, denial prevention, and reimbursement accuracy. This role focuses on inpatient and outpatient hospital claims. Physician billing experience a plus. Clinical experience strongly preferred to support medical necessity and documentation review.

Key Responsibilities

• Audit hospital inpatient and outpatient coding
• Review claim denials, underpayments, and appeals
• Identify coding, documentation, and medical necessity issues
• Apply ICD‑10‑CM/PCS, CPT, HCPCS and payer rules
• Support revenue integrity and denial reduction efforts
• Provide audit feedback and education to coding and revenue cycle teams

Qualifications

• Active credential: CCS, CPC, CIC, or CCS‑P
• 2+ years hospital coding or denial auditing experience
• Revenue cycle and payer guideline knowledge
• Experience with CMS and commercial payers
• Clinical background (RN or other) preferred