Medical Coders

Role: Medical Coder with Risk Management experience

Key Responsibilities:

• Accurately assign diagnosis codes following the Official ICD10CM Guidelines for Coding and Reporting. This includes coding for conditions relevant to the Center for Medicare & Medicaid Services Hierarchical Condition Categories (CMSHCC) covering the year(s) of service under review.
• Conduct thorough chart reviews by leveraging computerassisted coding tools to assess interpret and apply appropriate coding principles. This ensures valid diagnosis codes are supported by documented evidence in the medical record all done on the same day of service.
• Demonstrate a comprehensive understanding of CMSHCC guidelines to ensure the medical records align with standards including but not limited to signature requirements medical encounter types and places of service.
• Exhibit advanced knowledge of medical terminology anatomy and physiology to accurately assign diagnosis codes and capture supporting information from the medical record.
• Effectively manage the quality and productivity of individual work ensuring goals are met or exceeded.
• Perform necessary administrative duties as directed by the Team Lead/Operations Lead/Quality Lead.
• Consult with the Team Lead/Operations Manager or Subject Matter Expert (SME) in Coding as necessary to ensure accuracy and compliance.

Job Requirements and Qualifications

• License/Certification
• Must hold and maintain an active certification as a Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC) through the American Academy of Professional Coders (AAPC).
• Alternatively a Certified Coding Specialist (CCS) and/or Certified Coding Specialist Physicianbased (CCSP) through the American Health Information Management Association (AHIMA) is acceptable.

Education

• Associate Degree or equivalent HCC coding experience.

Skills

• Proficient in computer use including MS Windows MS Office and internetbased tools.
• Proficient in the use of official ICD10CM coding books or encoder software corresponding to the dates of service being reviewed.
• Demonstrates the ability to assign diagnosis codes accurately following the official guidelines and section/chapter level instructions.
• Ability to apply ICD10CM outpatient diagnosis coding guidelines.

Preferred Skills/Experience

• Knowledge of Hierarchical Condition Code (HCC) concepts.
• Familiarity with HIPAA regulations ensuring the protection of privacy security and confidentiality of medical records.
• Understanding of the AMA format and CMS HCC Risk Adjustment coding along with validation requirements.
• EMR/EHR experience preferred.

Job Type: Fixed term
Contract length: 4 months Nonrenewable

Hybrid: 2 days onsite and 3 days WFH

Shift: Midshift and Nightshift

Location: Taguig City

Remote Work :

No