Medical Coding Auditor - Inpatient DRG

MicroSourcing; Taguig; Hybrid; PHP 700,000 - 900,000; Full time

Benefits offered by this job

Healthcare coverage on day one

Dependent coverage

Paid time off with cash conversion

Group life insurance

Performance bonuses

Hybrid work arrangement

Job summary

MicroSourcing is looking for a Medical Coding Auditor - Inpatient DRG to join our hybrid, day-shift team in the Philippines. You will conduct quality reviews of inpatient coders to ensure coding accuracy and provide targeted education based on audit findings to support continuous quality improvement.

You will audit, prepare detailed coding audit reports, monitor guideline compliance, and present concise findings to leadership.

Qualifications

• Bachelor's degree in an allied health field.
• Active CCS, CIC, or CDIP certification.
• Extensive knowledge of medical terminology and MS-DRG/APR-DRG assignment.
• Experience with POA, SOI, ROM, HACs and PSIs.
• Hands-on EMR experience (Epic, Cerner, Meditech).
• Excellent English communication (CEFR B2).

Responsibilities

• Audit inpatient medical coders and perform "audit the auditor" quality reviews to maintain a minimum coding accuracy rate of 95%.
• Perform comprehensive quality checks and calibration audits per SOPs.
• Prepare detailed coding audit reports and provide actionable feedback to coders and auditors.
• Monitor compliance with coding guidelines and initiate corrective actions before claims are resubmitted.
• Analyze audit data and present findings to operational leadership.
• Maintain expert knowledge of inpatient coding, ICD guidelines, and reimbursement methods.
• Communicate effectively with internal and external stakeholders via phone, email, and chat.

Education

Bachelor's degree in allied health field

Certified Coding Specialist (CCS)

Certified Inpatient Coder (CIC)

Certified Documentation Improvement Practitioner (CDIP)

Master's degree in Business, Healthcare, or related field

Tools

Epic

Cerner

Meditech

3M Solventum

Encoder Pro

Codify

Job description

Discover your 100% YOU with MicroSourcing!

Position: Medical Coding Auditor - Inpatient DRG

Work setup & shift: Hybrid, Day shift

Why join MicroSourcing? You'll have:

Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time off with cash conversion, group life insurance, and performance bonuses.

A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.

Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.

Career Growth: Take advantage of opportunities for continuous learning and career advancement.

Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role:

As a Medical Coding Auditor - Inpatient DRG, you will be responsible for conducting quality reviews and audits of inpatient coders to ensure coding accuracy standards are consistently met. You will also provide targeted education and coaching based on audit findings to support continuous quality improvement.

Specifically, you will:

• Audit inpatient medical coders and perform specialized "audit the auditor" quality reviews to maintain a minimum coding accuracy rate of 95%.
• Perform comprehensive quality checks, audit visits in accordance with standard operating procedures (SOPs), and calibration audits.
• Prepare detailed coding audit reports and provide clear, actionable feedback to coders and auditors.
• Monitor compliance with coding guidelines, ensure identified errors are corrected, and initiate corrective actions before claims are resubmitted to insurance providers.
• Analyze audit data and present concise summaries of findings and workflow issues to operational leadership.
• Maintain expert knowledge of inpatient coding, clinical documentation guidelines, and reimbursement methodologies.
• Communicate effectively with internal and external stakeholders through phone, email, and instant messaging.

What You Need:

• At least 2 years of progressive experience in inpatient DRG coding auditing.
• Bachelor's degree in an allied health field (e.g., Nursing, Health Information Management, or equivalent).
• Active certification as a Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), or Certified Documentation Improvement Practitioner (CDIP).
• Extensive knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding, and MS-DRG/APR-DRG assignment.
• Proven proficiency in identifying POA (Present on Admission), SOI (Severity of Illness), ROM (Risk of Mortality), HACs (Hospital-Acquired Conditions), and PSIs (Patient Safety Indicators).
• Hands-on experience using electronic medical record (EMR) systems such as Epic, Cerner, or Meditech.
• Excellent verbal and written English communication skills (minimum CEFR B2 level).

Preferred skills/expertise

• Master's degree in Business, Healthcare, or a related field.
• Active PHRN or USRN license.
• AHIMA Auditing: Inpatient Coding (AIC) micro-credential or AAPC Certified Professional Medical Auditor (CPMA) certification.
• Experience supporting US healthcare providers or payers with a strong understanding of HIPAA standards.
• Experience using Computer Assisted Coding (CAC) platforms and encoder software such as 3M/Solventum, Encoder Pro, or Codify.
• Advanced Microsoft Office skills, particularly Excel, PowerPoint, and SharePoint.

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing believes our greatest strength is our people. We foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We value diverse perspectives and create opportunities for everyone to thrive.

At MicroSourcing, equality is more than a statement - it's our commitment. We don't just accept your authentic self; we celebrate it and recognize every individual's contribution to our shared success.

For more information, visit https://www.microsourcing.com/