IP Medical Coding Auditor

Nexus Recruitment Group; Makati; On-site; PHP 558,000 - 893,000; Full time

Job summary

Nexus Recruitment Group is seeking an IP Medical Coding Auditor in the Philippines, Metro Manila area. The role focuses on auditing coded medical records for accuracy, including ICD-10-CM/PCS, DRGs, and POA indicators, while ensuring compliance with HIPAA and CMS guidelines.

The ideal candidate will have a college degree, 2+ years of medical coding experience, and relevant certifications. The role involves collaboration with coders, preparation of detailed audit reports, and ongoing education to

Qualifications

• College degree or equivalent education.
• Preferred: Valid certification such as CCS, CPC, CCS-P, CIC, COC, CCA (or equivalent).
• Minimum of 2 years of medical coding experience with excellent performance evaluations.
• Strong attention to detail, analytical thinking, and communication skills.

Responsibilities

• Conduct audits of coded medical records to identify potential undercoding or upcoding.
• Prepare clear, detailed audit reports and communicate findings with coders to ensure proper coding practices.
• Review inpatient specialties including principal and secondary diagnoses, procedures (ICD-10 PCS), DRGs, POA indicators, and discharge dispositions.
• Stay up to date with official coding guidelines, CMS directives, and facility-specific instructions.
• Research coding updates, disease processes, and procedure details to support accurate audits.
• Participate in ongoing coding education sessions to remain current with changes in regulations and standards.
• Exercise independent judgment and maintain impartiality in audits.
• Utilize coding and auditing technologies effectively.
• Maintain confidentiality and adhere to HIPAA privacy and security policies.
• Provide coding support as needed and contribute to production when required.
• Collaborate effectively as part of a team and support departmental goals.
• Perform other related duties as assigned to meet evolving business needs.

Skills

Medical Coding

Auditing

Attention to detail

CMS Guidelines

HIPAA

Communication

Education

Bachelor's degree

Job description

Overview:

We are looking for a detail-oriented and knowledgeable IP Medical Coding Auditor to join our team. This role is vital in ensuring the accuracy, compliance, and quality of medical coding within our organization. The ideal candidate will have strong auditing skills, a solid understanding of coding guidelines, and the ability to provide constructive feedback and education to coding staff.

Key Responsibilities:

• Conduct audits of coded medical records to identify potential undercoding or upcoding.
• Prepare clear, detailed audit reports and communicate findings with coders to ensure proper coding practices.
• Review inpatient specialties including principal and secondary diagnoses, procedures (ICD-10 PCS), DRGs, POA indicators, and discharge dispositions.
• Stay up to date with official coding guidelines, CMS directives, and facility-specific instructions.
• Research coding updates, disease processes, and procedure details to support accurate audits.
• Participate in ongoing coding education sessions to remain current with changes in regulations and standards.
• Exercise independent judgment and maintain impartiality in audits.
• Utilize coding and auditing technologies effectively.
• Maintain confidentiality and adhere to HIPAA privacy and security policies.
• Provide coding support as needed and contribute to production when required.
• Collaborate effectively as part of a team and support departmental goals.
• Perform other related duties as assigned to meet evolving business needs.

Qualifications:

• College degree or equivalent education.
• Preferred: Valid certification such as CCS, CPC, CCS-P, CIC, COC, CCA (or equivalent).
• Minimum of 2 years of medical coding experience with excellent performance evaluations.
• Strong attention to detail, analytical thinking, and communication skills.

Why Join Us?

You’ll be part of a team that values accuracy, compliance, and professional growth. We provide opportunities for continuous learning, a supportive work environment, and the chance to make a meaningful impact on healthcare quality and compliance.