Quality Auditor, Medical Coding

Gratitude Inc

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1 month ago

Quality Auditor, Medical Coding

4-5 Year(s)

60 - 70 Thousand p.m

Manila (Taguig)

Job Description

Key Skills

medical coding Quality Auditor - Coding

1 candidate(s) have already applied for this Job. Apply now

Job Responsibilities
Perform daily coding audits based on assigned audit sample coverage

Maintain at least 95% quality accuracy while collaborating effectively with team members and leaders

Ensure compliance with the company’s Coding Compliance Policy for both internal and external (client) audits

Identify coder performance gaps and recommend improvements to enhance overall coding quality

Utilize and demonstrate working knowledge of the EPIC system

Educational Requirements

Must hold certification from AHIMA or AAPC

Registered Nurse (RN) is preferred but not required

At minimum, candidates must be college graduates

Experience Requirements
At least 4 years of medical coding experience

Prior BPO experience in medical coding is required

Strong working knowledge of:
Emergency Department (ED) and Observation coding

General surgical and bedside procedures

Injection & Infusion (I&I) coding, including:

IV push

Chemotherapy

Non-chemotherapy infusion

Hydration

Proficiency in:
Use of modifiers

Surgical supply charges

Resolving NCCI edits

Experience validating Revenue Codes:
0760 – Treatment/Observation Room

0762 – Observation Room

0761 and 0769 – Specific treatment rooms (as applicable)

Familiarity with:
Carve-out procedure times

HCPCS codes (e.g., G0378, G0379)

Medical necessity requirements

Role

Any Other

Timings

Flexible (Permanent)

Industry

BPO

Work Mode

Work from office

Functional Area

Any Other

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