Medical Coder

Global Resource For Outsourced Workers; Makati; On-site; PHP 334,800 - 502,200; Full time

Benefits offered by this job

Performance Bonus

Incentives

13th Month Pay

HMO

Diversity Program

Job Training

Professional Development

Job summary

Global Resource For Outsourced Workers in Makati is seeking a full-time Medical Records Auditor with 1-3 years of experience to ensure clinical documentation supports billed conditions. The role involves auditing medical records and utilizing coding expertise to identify errors. Benefits include performance bonuses, 13th month pay, and health insurance. Professional development opportunities such as job training and diversity programs are also available. This is a hybrid position based in Makati.

Qualifications

• 1-3 years of experience in medical auditing or related field.
• Knowledge of ICD-10 coding and clinical guidelines is essential.
• Broad understanding of medical claims billing and documentation improvement.

Responsibilities

• Audit inpatient medical records to verify clinical documentation accuracy.
• Analyze claims using medical chart coding principles.
• Identify errors in coding and documentation patterns.

Education

Bachelor's degree

Job description

Hybrid - Makati 1-3 Yrs Exp Bachelor Full-time

Job Description

Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims.

Primary duties may include but are not limited to:

• Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities.
• Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions.
• Utilizes audit tools, auditing workflow systems and reference information to generate audit determinations and formulate detailed audit findings letters.
• Maintains accuracy and quality standards as established by audit management.
• Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs).
• Suggests and develops high quality, high value, concept and or process improvement and efficiency recommendations.
• Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred.

Employee Recognition and Rewards

Performance Bonus, Incentives

Government Mandated Benefits

13th Month Pay

Insurance Health & Wellness

HMO

Professional Development

Diversity Program, Job Training, Professional Development