Medical Coding Auditor – Healthcare Reimbursement Expert

Cotiviti Philippines Inc; Manila; On-site; PHP 424,000 - 759,000; Full time

Job summary

Cotiviti Philippines Inc. is seeking an Auditor to support a growing client base by combining clinical and coding expertise with payment accuracy.

The Auditor analyzes and assigns the correct codes for medical procedures and diagnoses in line with policy requirements. Ideal candidates are Registered Nurses with CIC/CCS certification, have US healthcare coding experience, and are willing to work US hours during training.

Qualifications

• Registered Nurse (RN) with CIC/CCS certification.
• Experience in US Healthcare, medical coding, medical billing or RCM preferred.
• Knowledge of CMS, Medicaid, ICD-10-CM & DRG concepts desired.

Responsibilities

• Perform daily audits on client data for completeness and accuracy of coding.
• Respond to provider appeals and client logics/record reviews.
• Monitor acceptance rates and assist in detecting deviations.
• Report work performance to team lead and meet productivity/quality benchmarks.
• Participate in ongoing training and development activities.

Skills

Analytical thinking

Verbal & written communication

Rapid learning

Organization

Independent work

Education

Nursing degree

CIC/CCS certification

Tools

Microsoft Word

Excel

PowerPoint

Outlook

Job description

Cotiviti Philippines Inc. is seeking an Auditor to support a growing client base by combining clinical and coding expertise with payment accuracy.

The Auditor analyzes and assigns the correct codes for medical procedures and diagnoses in line with policy requirements. Ideal candidates are Registered Nurses with CIC/CCS certification, have US healthcare coding experience, and are willing to work US hours during training.