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medical coders

2 months ago

Manila, National Capital Region, Philippines Pan Asia Resources PH Inc. Full time

Key roles:

· Assigns diagnosis codes according to the Official ICD-10-CM Guidelines for Coding and Reports for conditions which map to the Center for Medicare & Medicaid Services' Hierarchical Condition Categories (CMS-HCC) applicable for the year(s) of service being reviewed

· Conducts thorough review of charts by effectively using computer-assisted coding tools to review and interpret medical records, and applies in-depth knowledge of coding principles to assign valid diagnosis codes which are supported by evidence in the medical record on the same date of service

· Demonstrates knowledge of what constitutes a medical record acceptable for supporting CMS-HCCs, including signature guidelines, member identifiers, provider types, medical record encounter/visit types, and places of service

· Demonstrates advanced knowledge of medical terminology, anatomy and physiology as they pertain to assigning appropriate codes and identifying pertinent supporting information in the medical record

· Manages individual quality of work & productivity toward meeting or exceeding targets.

· Performs administrative tasks and work as directed by Team Lead/Operations Lead/Quality Lead.

Consults Team Lead/Operations Manager and/or Coding SME timely and appropriately.

License / Certification: Holds and maintains active Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC) certification through the American Academy of Professional Coders OR Certified Coding Specialist (CCS) and/or Certified Coding Specialist – Physician based (CCS-P) through American Health Information Management Association (AHIMA)

Education: Associate Degree or equivalent HCC coding experience

Skills:

· Computer proficiency

· Ability to use an official ICD-10-CM code book or Encoder software which corresponds to the date(s) of service being reviewed to assign diagnosis codes appropriately and according to official guidelines and section/chapter level instructions

· Knowledge of and ability to apply ICD-10-CM outpatient diagnosis coding guidelines

Preferred Skills/Experience:

· Knowledge of Hierarchical Condition Code concepts

· Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical records and member information.

· Knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements preferred

· EMR/EHR experience preferred

· Related outsourcing/vendor operations experience preferred

· 2 years risk adjustment coding experience preferred

Working Conditions

· Able and willing to work U.S. time and as needed, overtime hours (i.e., night shift)

· Employees must be able and willing to travel to and work from locations determined at the discretion of project leadership

· Additional tasks not indicated may be assigned by immediate supervisor/project manager/leadership

· Some travel may be required over the course of the role

· Cyclical work shift including work hours at night and weekends. Overtime and On-Call may be requested.

Must be amenable to a 4 month contractAvailable to onboard by 1st week of October