Operations Manager [Inpatient Medical Coding]

Swift-up; Metro Manila; On-site; PHP 540,000 - 720,000; Full time

Job summary

Swift-up is seeking an experienced supervisor to lead the inpatient medical record coding team in a hospital setting. You will oversee review, coding, abstraction, and audits to ensure accuracy and compliance with DRG guidelines.

The role requires strong supervisory skills, advanced ICD-10-CM/PCS knowledge, and the ability to train staff while maintaining high data quality and ethical coding practices.

Qualifications

• 3–5 years in inpatient coding with supervisory or management responsibility.
• Must have CCS/CIC/CPC certifications.
• Advanced knowledge of ICD-10-CM and ICD-10-PCS.
• Ability to read, interpret and evaluate complex technical reports.

Responsibilities

• Supervise inpatient medical record coding team.
• Establish and maintain a formal review process for coding compliance and audits.
• Perform data quality reviews and DRG validation.
• Create and monitor DRG reports to identify patterns and variations.
• Train healthcare professionals in coding guidelines and documentation.
• Enforce ethical coding standards and report concerns to leadership.

Skills

Inpatient coding

Supervisory experience

Medical terminology

ICD-10-CM/PCS knowledge

Report interpretation

Education

CCS/CIC/CPC certifications

Job description

About the role

Under direction, supervises the work of staff who review, interpret, code and abstract medical records information according to standard classification systems; performs the most advanced medical records coding and abstraction duties; performs data quality reviews and prepares complex reports as required; and performs other related duties as assigned.

Key responsibilities

• Supervises and performs a wide range of activities pertaining to the review and coding of inpatient medical record information
• Establishes, implements and maintains a formalized review process for coding compliance, including a formal review (1st level audit) process; designs and uses audit tools to monitor the accuracy of clinical coding
• Performs data quality reviews on inpatient records to validate the International Classification of Diseases Manual (ICD-10-CM), and other codes; verifies Diagnosis Related Group (DRG) group appropriateness; checks for missed secondary diagnoses and procedures and ensures compliance with all DRG mandates and reporting requirements
• Creates and monitors inpatient case mix reports and the top DRG's to identify patterns, trends and variations in the facility's frequently assigned DRG groups; investigates and evaluates potential causes for changes or problems
• Continuously evaluates the quality of clinical documentation to identify incomplete or inconsistent documents for inpatient encounters that impact the code selection and resulting DRG groups and payment
• Provides or arranges for training of healthcare professionals in the use of technical coding guidelines and practices, proper documentation techniques, medical terminology and disease as they relate to the DRG, and other data quality management
• Selects, assigns, and collaborates with the training department to educate subordinate technical and clerical staff; directs, monitors and evaluates work; reviews and makes decisions regarding leave requests; initiates and implements disciplinary action as needed
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association; reports areas of concern to the Director
• Monitors unbilled account reports for outstanding services or un-coded discharges to reduce accounts receivable days for inpatients; performs periodic claim form reviews to check code transfer accuracy
• Recommends and implements standardized, organization-wide coding guidelines and documentation requirements; develops and implements training and educational programs for coders

About you

• Minimum of 3-5 years of Inpatient coding including prior supervisory or management responsibility
• Must have the following certifications: CCS/CIC/CPC
• Advanced principles and practices of medical record keeping; advanced medical terminology, anatomy, and physiology, as well as the states, sequence, progression and description of diseases as they apply to medical record coding and abstraction
• Advanced elements of ICD-10-CM, and ICD-10-PCS coding systems
• Ability to read, interpret and evaluate complex technical reports and information

NOTE: OPEN SALARY