IP Medical Coding Auditor w/ 90K SOB | WORK FROM HOME

Coronis Health Philippines; Philippines; Sur place; PHP 320 000 - 520 000; Plein temps

Résumé du poste

Coronis Health Philippines is seeking a Medical Coding Auditor responsible for auditing medical records coded by coders and communicating findings to improve accuracy. The role ensures compliance with coding guidance, facility guidelines, and confidentiality standards.

The auditor will prepare reports, educate coders on errors, and stay current with ICD-10 guidelines and CMS directives to support quality and compliance. Reports line to Operations and Quality and requires teamwork and discretion.

Qualifications

• College diploma or equivalent.
• Preferred CCS/CPC/CCS-P/CIC/COC/CCA or equivalent coder certification.
• At least 2 years coding experience within the organization with excellent annual evaluation.

Responsabilités

• Audits medical records that are coded to identify possible undercoded and/or upcoded services.
• Prepares reports of the findings and educates coders on errors in line with coding practices and compliance issues.
• Maintains confidentiality of information and adheres to HIPAA policies.
• Keeps updated with Official Coding Guidelines and CMS directives for ICD-10 coding to provide accurate audit feedback.
• Attends coding education sessions to receive updated coding information and changes in regulations.

Connaissances

Auditing

Medical coding

HIPAA compliance

Communication

Formation

College diploma or equivalent

Outils

CPT

Description du poste

Medical Coding Auditor is responsible in maintaining accurate audit to medical records coded by the coders and communicate with them on the findings. Auditor must ensure compliance to coding guidance, facility specific instructions and confidentiality of information. Reviews and develop reports essential for quality and compliance standards. Medical coding auditor reports to Operations and Quality.

Essential Functions:

• Audits medical records that are coded to identify possible undercoded and/or upcoded services.
• Prepares reports of the findings and meets with the respective coder to communicate clearly the errors and provide education in line with appropriate coding practices and compliance issues.
• Outpatient Specialty: principal diagnosis, secondary diagnosis, procedures (CPT, HCPCS II), modifiers, Ambulatory Payment Classification (APC)
• Stays current with Official Coding and reporting Guideline, CMS directives for ICD 10 coding and conducts intensive research for acceptable source of references in coding updates, disease process, procedure details etc., to provide accurate audit and feedback to coding staff.
• Keeping updated to facility specific guidelines and compliance to ensure accuracy in auditing.
• Attends necessary coding education sessions to receive updated coding information and changes in coding and/or regulations.
• Able to think independently and impartial judgment.
• Able to adapt on technologies use in coding and auditing.
• Maintains confidentiality of information.
• Adheres to all HIPAA privacy and security policies and practices. Reports violations and incidents they observe and cooperates in investigations as requested by management.
• Capable of doing coding to its minimum as needed in the production.
• Perform as a team player
• Adhere to the individual MiraMed Coding Compliance Guideline Policy and Procedure
• Attendance in accordance with company HR and department policies
• Other tasks/functions that may be assigned by the company as per business requirement; these may change from time to time to reflect the changing requirement of your position and our business

Qualifications:

• College diploma or equivalent.
• Preferably possess a current CCS/CPC/CCS-P/CIC/COC/CCA (or equivalent) medical coder certification.
• Must have at least two (2) years coding experience within the organization and excellent annual evaluation rating.