Inpatient Medical Coder

4 days ago

Metro Manila, Philippines COTIVITI Philippines Full time

PRINCIPLE PURPOSE OF JOB
We are currently seeking Auditor to support a growing client base while combining their clinical
and/or coding expertise with payment accuracy. The Auditor is responsible for analyzing and
interpreting and assign the correct codes for the descriptions available on various medical
procedures and diagnosis and other related medical coding as per the medical policy
requirements.


JOB RESPONSIBILITIES
• Perform daily audits on client data for completeness and accuracy of coding utilizing
both coding and clinical background to ensure appropriateness for reimbursement
• Respond to provider appeals
• Respond to client logics and record reviews
• Monitor acceptance rates for assigned clients and assist management in proactively
detecting negative deviations
• Reports his/her work performance on a timely basis to the team lead
• Works diligently to meet and exceed productivity and quality benchmarks
• Takes charge of ongoing learning and development and participates in relevant training
and development activities
• Willing to work in US hours during training, which may last for 8 to 12 weeks. Thereafter shift
timing will overlap US working hours for couple of hours based on business requirements.
• Required to work from office
• Works effectively in co-ordination with the India team


ATTRIBUTES AND BEHAVIORS
• Develops and maintains positive working relationships with others
• Shares ideas and information Ability to collaborate efficiently
• Assists colleagues unprompted
• Takes pride in the achievement of team objectives
• Has credibility with peers and senior managers
• Self-motivated – driven to achieve results
• Works with a sense of urgency
• High customer service ethic – is passionate about meeting customer expectations and
improving service levels
• Keeps pace with change – acquires knowledge/skills as the business evolves
• Handles confidential information with sensitivity


RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS
• Medical coders with CIC or CCS certification with prior DRG experience (at least 1-2 years’ experience)
➢ Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred
➢ Possesses knowledge of healthcare claims payment policy and processing 
specifically, CMS, Medicaid regulations, ICD-10 CM & DRG Expert, etc
➢ Has general knowledge of medical procedures, conditions, illnesses, and
treatment practices
➢ Possesses excellent written and verbal communication skills. Ability to think logically
and process sequentially with a high level of detailed accuracy and efficiency
➢ Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.


SKILLS & COMPETENCIES
• Strong analytical, critical thinking and problem-solving skills
• Excellent verbal and written communication skills
• Be a quick learner and proficient in application of learnings
• Excel proficiency
• Strong organizational skills and adaptive capacity for rapidly changing priorities and
workloads
• Ability to work well independently and maintain focus on a topic for prolonged periods
of time

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