(ACTIVE) PHRN Risk Adjustment Medical Coder Team Leader_TWFH | Non-Voice

Gratitude Inc

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5 hours ago

(ACTIVE) PHRN Risk Adjustment Medical Coder Team Leader_TWFH | Non-Voice

2-8 Year(s)

Cebu Central Visayas
(Base Location for WFH)

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Job Description

Key Skills

Performance Management people Management PHRN CPC Healthcare Operation ICD-10 Medical Claims processing team leadership Billing, Medical Claims or RCM. Clinical documents CPC certification SME/ People Manager experience Risk Adjustment Coder

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Risk Adjustment Medical Coder Team Leader (Non-Voice)

Job Title: Risk Adjustment Medical Coder – Team Leader
Work Setup: Temporary WFH
Work Schedule: Shifting
Location: All locations in the Philippines – BGC Taguig, Cebu, Davao, Clark Pampanga
Start Date: ASAP
Headcount: 5

Job Summary

We are looking for an experienced Risk Adjustment Medical Coder Team Leader to lead and support coding operations in a non-voice healthcare environment. The ideal candidate should have strong Risk Adjustment Coding expertise along with experience as an SME, Team Leader, Supervisor, or people manager.

Key Responsibilities

Perform and oversee Risk Adjustment Medical Coding activities.
Review medical records and clinical documentation for accurate risk adjustment coding.
Ensure coding accuracy and compliance with applicable coding guidelines.
Provide guidance, coaching, and support to medical coders.
Act as an SME for coding-related queries and escalations.
Monitor team performance, productivity, and quality.
Conduct quality checks and identify coding errors or improvement areas.
Support team members with complex coding cases.
Maintain accurate documentation and coding records.
Collaborate with internal teams to resolve coding and process-related issues.
Ensure adherence to organizational quality and compliance standards.

Qualifications

2–3 years of Risk Adjustment Coding experience.
Minimum 1 year of SME / Team Leader / Supervisor / People Manager experience.
Must have an active PHRN license.
Must hold an active CPC certification for Risk Adjustment Coding (RA Coder).
Strong knowledge of medical coding and risk adjustment concepts.
Strong communication, analytical, and leadership skills.
Willing to work on a shifting schedule.
Willing to work under a temporary WFH arrangement.

Required Certification

CPC – Risk Adjustment Coder

Recruitment Process

Validation → Talkpush Profile Creation → HR Interview → Hiring Manager Interview → Onboarding

Pre-Screening Questions

What is your current location and preferred site to work?
Do you have an active PHRN license? Please provide the validity date.
Do you hold an active CPC (RA Coder) certification? Please provide the validity date.
How many years of Risk Adjustment Coding experience do you have?
How many years of experience do you have as a Team Leader, Supervisor, People Manager, or SME?
What is your last drawn salary?
What are your salary expectations?
What is your notice period?

Role

Admin Services/Medical Facilities

Timings

Rotational Shifts (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Work from Home

Process

Non-Voice

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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