Quality Auditor, Medical Coding

Gratitude Inc

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2 days ago

Quality Auditor, Medical Coding

4-8 Year(s)

Manila (Taguig)

Job Description

Key Skills

medical coding BSRN BPO Experience Quality Auditor AHIMA or AAPC certified

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Quality Auditor, Medical Coding

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

QA Analyst

Timings

Rotational Shifts (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Work from office

Functional Area

ITES / BPO / Customer Service

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