MEDICAL CODING QUALITY AUDITOR - INPATIENT

Work Information

• Office is at Robinson Cyber Sigma, Mckinley West Taguig
• Work schedule is 8am to 5pm
• HMO upon hire plus dependent

Responsibilities

• Perform a variety of medical coding- related activities including seamless assignment of codes and assessing accurate assignment of codes to diagnosis and procedures, which includes CPT, ICD-10, PCS, HCPCS, Modifiers, POA, & abstracting based on the medical records and query the physicians as required per defined protocols.
• Understand and ensure adherence to the client specifications, coding clinics, coding guidelines, HIPPA and GRIC requirements.
• Meet Audit Production & Error Identification rates specified for the project.
• Perform different levels of audits or review processes and capture the feedback and references in the assigned tools for tracking and feedback purposes.
• Review and provide appropriate responses and educational guidance on rebuttals.
• Participate and support leaders to drive Quality Improvement Initiatives.
• Support Knowledge Assessment Survey and Quality Tips.
• Focus on updating coding skills, knowledge and improve quality by actively participating and supporting relevant meetings and educational sessions.

Your Success Profiles includes:

• Bachelor's degree in Life Science, Pharmacy, Physiotherapy, or Paramedical stream of discipline.
• Minimum 2 years of experience in respective specialty coding- Inpatient DRG Coding/ Emergency Department Coding (Facility / Hospital Billing).
• Valid coding certifications like CPC, CCS from AHIMA or AAPC is required.
• Should possess strong subject knowledge specific to Emergency Department (E/M, CPT, Injections and Infusions & ICD-10)/ or Inpatient DRG (MS-DRG/ APR DRG with ICD-10 & PCS) Coding for Hospital or Facility billing setup.
• Excellent skills on the required Process/ Speciality Coding
• Quick learner of related processes and new billing systems navigation.
• Good communications and Interpersonal skills.
• Ability handle process disputes/ conflicts in matured manner.

 

A successful candidate should be prepared to submit and complete the following as part of onboarding requirements.

• Scanned copy of valid NBI Clearance

• Accomplished Medical or PEME Slip

• 2x2 & Half body picture with white background

• Proof of government numbers (TIN, SSS, Pag-ibig, & Philhealth).

• Photocopy of 2 valid IDs – front & back (government-issued)

• Clear copy of your Birth Certificate (PSA or NSO)

• Accomplished HR Forms & Promissory Note (will be provided by KMC’s Onboarding Team)