Medical Coder (Junior level)

Job Highlights

  • laptop to be provided 
  • Upon regularization 30 paid leaves per year
  • Upon regularization HMO for you PLUS 1 dependent worth P150,000

Role Summary

1

Responsibilities

  • Assigns diagnosis codes according to the Official ICD-10-CM Guidelines for Coding and Reports for conditions which map to the Center for Medicare & Medicaid Services’ Hierarchical Condition Categories (CMS-HCC) applicable for the year(s) of service being reviewed
  • Conducts thorough review of charts by effectively using computer-assisted coding tools to review and interpret medical records, and applies in-depth knowledge of coding principles to assign valid diagnosis codes which are supported by evidence in the medical record on the same date of service
  • Demonstrates knowledge of what constitutes a medical record acceptable for supporting CMS-HCCs, including signature guidelines, member identifiers, provider types, medical record encounter/visit types, and places of service
  • Demonstrates advanced knowledge of medical terminology, anatomy and physiology as they pertain to assigning appropriate codes and identifying pertinent supporting information in the medical record
  • Manages individual quality of work & productivity toward meeting or exceeding targets.
  • Performs administrative tasks and work as directed by Team Lead/Operations Lead/Quality Lead.
  • Consults Team Lead/Operations Manager and/or Coding SME timely and appropriately.

Qualifications

  • The ideal candidate must possess a Bachelor of Science in Nursing, Other Allied Health graduate, Associate Degree or equivalent HCC coding experience
  • Must holds and maintains active Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC) certification through the American Academy of Professional Coders OR Certified Coding Specialist (CCS) and/or Certified Coding Specialist – Physician based (CCS-P) through American Health Information Management Association (AHIMA)
  • Must have 2 years of experience in risk adjustment coding
  • Knowledge of Hierarchical Condition Code concepts
  • Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical records and member information
  • Knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements preferred
  • EMR/EHR experience preferred
  • Related outsourcing/vendor operations experience preferred
  • Computer proficiency (including MS Windows, MS Office, and the internet)
  • Ability to use an official ICD-10-CM code book or Encoder software which corresponds to the date(s) of service being reviewed to assign diagnosis codes appropriately and according to official guidelines and section/chapter level instructions
  • Knowledge of and ability to apply ICD-10-CM outpatient diagnosis coding guidelines
  • Must be amenable to undergo 2 weeks of face-to-face training in BGC, Taguig. After training, will then proceed to a hybrid setup.

 

 

 

 

 

Technical Environment

Additional Information

Career Level

Junior

Work Location

Taguig

Work Setup

Hybrid (2x a week onsite) | Mid Shift

Job Type

Project Based

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