Quality Auditor, Medical Coding

Gratitude Inc

672 Views

2 months ago

Quality Auditor, Medical Coding

4-5 Year(s)

₱ 65 - ₱ 70K p.m

Manila

Job Description

Key Skills

medical coding BSRN BPO Experience Quality Auditor AHIMA or AAPC coding

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Role Overview

Job Title: Quality Auditor, Medical Coding
Salary: Competitive increase from current, up to Php 70,000
Work Setup: On-site at MCK West, Taguig
Eligibility Note: Former employees of AGS are not eligible for rehire through any channel

Core Responsibilities

Audit Execution: Conduct daily coding audits based on assigned sample sizes to ensure data integrity
Accuracy Standard: Maintain a minimum quality accuracy rate of 95% while collaborating with team leads
Compliance: Adhere strictly to the company’s Coding Compliance Policy for both internal and external client audits
Performance Improvement: Detect gaps in coder performance and provide actionable recommendations to raise quality standards
Systems: Demonstrate proficiency in utilising the EPIC system for daily tasks

Technical Qualifications

Certification: Must hold a valid certification from either AHIMA or AAPC
Experience: Minimum of 4 years in medical coding, specifically within a BPO environment
Education: College graduate at minimum; Registered Nurse (RN) status is preferred

Required Technical Knowledge

Coding Specialities: Expertise in Emergency Department (ED), Observation, and General Surgical coding
Injection & Infusion (I&I): Proficiency in coding for IV push, Hydration, and both Chemotherapy and Non-chemotherapy infusions
Financial Validation: Experience validating Revenue Codes (0760, 0761, 0762, 0769) and resolving NCCI edits
HCPCS & Modifiers: Strong grasp of HCPCS codes (G0378, G0379), surgical supply charges, and the correct application of modifiers
Medical Necessity: Solid understanding of medical necessity requirements and carve-out procedure times

Available to Start Immediately.

Role

Medical Specialist

Timings

Flexible (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Work from office

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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