Hybrid Medical Coding Auditor (CPC/COC) — Growth & Impact

Optum, a UnitedHealth Group Company; Makati; Hybrid; PHP 360,000 - 520,000; Full time

Benefits offered by this job

Hybrid Work Set-up

Market Total Rewards Package

Retirement Plan

Medical Plan (HMO) from Day 1 of emplo

Job summary

Optum, a UnitedHealth Group Company, is seeking a skilled Medical Coder in Makati to review and audit healthcare documentation and translate diagnoses and procedures into accurate medical codes. The role supports compliant claims processing and must align with current coding guidelines.

Candidates should have a 4-year Medical Allied degree, active CPC/COC certification, and an active PRC license, plus at least 2 years in Medical Coding (CPC-A welcome with 3+ years).

Qualifications

• Graduate of a 4-year Medical Allied course.
• Must possess an active CPC or COC certification.
• Must have an active PRC license (preferred for licensed healthcare professionals).
• At least 2 years of Medical Coding experience (CPC-certified).
• CPC-A holders are welcome to apply with at least 3 years of Healthcare Claims Processing experience.
• Knowledgeable in medical terminology, anatomy, physiology, disease processes, and healthcare documentation.
• Experience in Outpatient Coding, Home Health Coding, Emergency Department Coding, Same Day Surgery (SDS), or related coding specialties is an advantage.
• Strong attention to detail with ability to interpret and analyze medical records accurately.
• Must be willing to work in a hybrid setup in Makati City.
• Must be willing to commit to long-term employment and continuous learning within the Medical Coding profession.

Responsibilities

• Reviewing and auditing healthcare documentation to ensure coding accuracy.
• Analyzing and translating medical and clinical diagnoses, conditions, injuries, illnesses, and procedures into designated medical codes.
• Reviewing medical records and applying current coding guidelines, compliance requirements, reimbursement guidelines, and payment policies to ensure accurate coding and claims processing.
• Performing coding validation and quality reviews to identify documentation deficiencies, coding discrepancies, and compliance concerns.
• Maintaining productivity and quality standards while adhering to turnaround times and organizational goals.
• Collaborating with healthcare providers, quality teams, and operational stakeholders to support accurate documentation and coding outcomes.

Skills

CPC or COC certification

Active PRC license

Medical terminology

CPC-A eligible

Education

4-year Medical Allied course

Job description

Optum, a UnitedHealth Group Company, is seeking a skilled Medical Coder in Makati to review and audit healthcare documentation and translate diagnoses and procedures into accurate medical codes. The role supports compliant claims processing and must align with current coding guidelines.

Candidates should have a 4-year Medical Allied degree, active CPC/COC certification, and an active PRC license, plus at least 2 years in Medical Coding (CPC-A welcome with 3+ years).