Denials Auditor & Medical Coding Expert

Rev Pro; Philippines; On-site; PHP 360,000 - 600,000; Full time

Job summary

Rev Pro in the Philippines is seeking a Coding Denials Auditor / Medical Coder to review inpatient, outpatient, and professional claims for accurate ICD-10-CM/PCS and CPT coding and to ensure compliant reimbursement.

You will audit bills, support denial appeals, mentor colleagues, and collaborate with revenue cycle teams to resolve complex cases. Onsite full-time position requiring strong Excel skills and up-to-date coding knowledge.

Qualifications

• Current CPC certification.
• Proficient knowledge of ICD-10, PCS, CPT, HCPCS.
• 2+ years of inpatient, outpatient, or physician coding.
• Strong background in billing/coding, including AR, EOBs, and revenue cycle management.
• Experience managing coding denials and preparing appeals.
• Knowledge of Medicare, Medicaid, and Commercial payer guidelines.
• Analytical, problem-solving, and research skills.
• Time management and ability to work independently.
• Experience with CAC/Encoder audits and code selection.

Responsibilities

• Conducts coding audits of submitted claims to determine appropriateness of procedure and diagnosis codes billed based on documentation provided for inpatient and outpatient facility claims.
• Reviews billing for accuracy to ensure compliance of proper billing and coding procedures of third-party carriers and to ensure complete and accurate reimbursement.
• Coordinates with revenue cycle teams to investigate rejected or denied claims to determine denial accuracy and work in an inter-departmental collaboration process to assist in claim corrections/appeals.
• Collaborates with other senior coders to share coding information and provide coding advice on complex cases.
• Utilizes MS Office (Excel at basic-intermediate level) to produce required correspondence, charts, and spreadsheets.
• Applies knowledge of anatomy, physiology, and pharmacology to determine ICD-10-CM/PCS and CPT-4 assignments for claims and appeals.
• Reviews patient records for accuracy, DRG assignment, POA, discharge disposition and related data for accurate coding.
• Mentors other coders during orientation and supports policy and coding concept training.
• Serves as SME on ethical coding and documentation standards for internal and external stakeholders.
• Assists manager with special projects and communicates with senior leadership on critical issues.
• Keeps up-to-date with medical coding and healthcare market changes.

Skills

CPC Certification

ICD-10

CPT

PCS

Medical Terminology

Revenue Cycle

Audit & Denials

Excel

Denials & Appeals

Education

CPC Certification – AAPC

Tools

CAC/Encoder

Microsoft Excel

Job description

Rev Pro in the Philippines is seeking a Coding Denials Auditor / Medical Coder to review inpatient, outpatient, and professional claims for accurate ICD-10-CM/PCS and CPT coding and to ensure compliant reimbursement.

You will audit bills, support denial appeals, mentor colleagues, and collaborate with revenue cycle teams to resolve complex cases. Onsite full-time position requiring strong Excel skills and up-to-date coding knowledge.