PHRN Medical Coder - Claims Review & Payment Integrity

Private Advertiser; Metro Manila; On-site; PHP 420,000 - 660,000; Full time

Job summary

Private Advertiser seeks a detail-oriented healthcare professional to support medical coding, claims review, and payment integrity activities, reviewing claims and clinical documentation to ensure coding accuracy and alignment with reimbursement guidelines.

Ideal candidates are PHRN with 1-2 years hospital experience, CPC/CCS certification, knowledge of CPT/ICD-10-CM/PCS, HCPCS, and payer policies, with strong analytical and investigative skills to detect discrepancies, support adjudication, and

Qualifications

• Must be a Philippine Registered Nurse (PHRN) with 1–2 years of hospital-based clinical experience.
• Certification CPC or CCS required.
• 1–2 years of experience in Medical Coding, Claims Review, Payment Integrity, Revenue Cycle Management, or related healthcare field.
• Strong working knowledge of CPT, ICD-10-CM/PCS, HCPCS, and clinical documentation standards.
• Ability to identify coding errors, billing discrepancies, and potential Fraud, Waste, and Abuse (FWA) indicators.
• Strong analytical, investigative, and critical thinking skills.
• Knowledge of payer policies, reimbursement methodologies, regulatory requirements, and compliance standards.

Skills

PHRN

CPC/CCS

Medical Coding

CPT/ICD-10

FWA indicators

Analytical skills

Payer policies

Job description

Private Advertiser seeks a detail-oriented healthcare professional to support medical coding, claims review, and payment integrity activities, reviewing claims and clinical documentation to ensure coding accuracy and alignment with reimbursement guidelines.

Ideal candidates are PHRN with 1-2 years hospital experience, CPC/CCS certification, knowledge of CPT/ICD-10-CM/PCS, HCPCS, and payer policies, with strong analytical and investigative skills to detect discrepancies, support adjudication, and