Remote Denials & Medical Coding Edits Specialist

MED-METRIX INTERNATIONAL PH-I, INC.; Metro Manila; Remote; PHP 350,000 - 550,000; Full time

Benefits offered by this job

8-hour shifts

Fixed weekends off

Day 1 HMO with dependents covered

Medical cash allowance

Rice allowance

Clothing allowance

Paid time off

Training and staff development

Employee engagement activities

Internal mobility opportunities

Job summary

Med-Metrix International PH-I, INC. is seeking a Denials Management Coder responsible for reviewing denied claims for coding errors and applying corrections to CPT/ICD-10 codes, modifiers, and related actions.

The role ensures compliance with government and local guidelines across payers including Medicare, Medicaid, Blue Cross, and commercial carriers. The position requires at least 1 year of coding experience in denials, familiarity with Medicare/Medicaid guidelines, HIPAA/PHI adherence, and

Qualifications

• CPC/COC certification (AAPC) or CCS certification from AHIMA.
• Minimum one year of coding experience related to the specialty (Coding Denials).
• Knowledge in Medicare and Medicaid guidelines preferred.
• Working knowledge of managed care, commercial insurance, Medicare/Medicaid.
• Understanding and adherence to HIPAA and PHI Guidelines.
• Strong interpersonal skills, ability to communicate well at all levels of the organization.
• High level of integrity and dependability with a strong sense of urgency and results oriented.
• Excellent written and verbal communication skills required.
• Documentation and data entry skills.
• Gracious and welcoming personality for customer service interaction.

Responsibilities

• Read and interpret insurance carrier EOBs.
• Review medical reports, verify coding.
• Resolve coding related denial.
• Make any necessary coding corrections.
• Generate replacement claims (electronic and paper)
• Research carrier specific coding policies.
• Review and interpret carrier NCD and LCD policies.
• Communicate any coding denial trends to coding manager.

Skills

CPC/COC (AAPC) or CCS

1 year coding experience

Medicare/Medicaid knowledge

Managed care knowledge

HIPAA/PHI guidelines

Interpersonal skills

Integrity & reliability

Written & verbal communication

Documentation/data entry

Customer service attitude

Job description

Med-Metrix International PH-I, INC. is seeking a Denials Management Coder responsible for reviewing denied claims for coding errors and applying corrections to CPT/ICD-10 codes, modifiers, and related actions.

The role ensures compliance with government and local guidelines across payers including Medicare, Medicaid, Blue Cross, and commercial carriers. The position requires at least 1 year of coding experience in denials, familiarity with Medicare/Medicaid guidelines, HIPAA/PHI adherence, and