PHRN Medical Coding Academy

4 weeks ago


Davao City, Davao, Philippines Private Advertiser Full time
Maintains high performance levels in accuracy and productivity. Understands ICD, CPT, and HCPCS coding guidelines. Stays up-to-date with coding knowledge and guidelines. Identifies fraudulent claims and diagnoses based on medical records and coding guidelines. Reviews medical records for under/over coding and irregular billing patterns. Ensures compliance with legal and procedural policies for optimal reimbursement. Key Responsibilities:
  • Prevent potentially fraudulent and/or abusive claims
  • Identify diagnoses and procedures based on CPT and ICD codes
  • Review medical records for under/over coded services
  • Research new or additional irregular billing patterns
  • Interpret and analyze medical records for statistical indexing and accurate reimbursement
  • Review billing performances for compliance and optimal reimbursement
Qualifications:
  • BS Nursing degree with board pass
  • Active PHRN license
  • AAPC or AHIMA certified or equivalent coding certification
  • Medical coding experience preferred
  • Claims processing experience in a BPO/HMO setting a plus


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