CRI - Outpatient Coding Quality Auditor

4 weeks ago

Taguig, Philippines Conifer Health Solutions Full time

Overview

The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient, and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as corporate coding compliance policies. The Quality Auditor’s role is designed to ensure the integrity of Conifer’s coding program is consistently maintained. The Coding Quality Auditor will deliver written and verbal reports of findings to other department staff members, as well as hospital, region, and/or corporate operations staff as indicated. The Senior Coding Quality Auditor will escalate significant trends to Manager of Coding Quality & Performance, leadership and/or Conifer Compliance team as warranted.

  • Understands, interprets and applies coding guidelines for coding quality audits. Audits inpatient, and profee encounters with complex code assignments.
  • Review of complex medical records to determine coding accuracy of all documented diagnoses and procedures.
  • Reviews claims to validate submitted codes and abstracted data including but not limited to ICD-10-CM/PCS codes, MS-DRGs, APR-DRGs, CPTs, APCs, and discharge disposition which all facility reimbursement and RVUs which impact profee reimbursement.
Required Certifications/Licensure
  • Coder Certification such as CCS, COC, CPC
Working Conditions
  • Amenable to work in BGC
  • Willling to work in a dayshift schedule
Company Benefits
  • HMO with FREE dependents
  • Group life insurance
  • PTO Credits
  • Annual Performance Bonus
  • 50K SIGN-ON BONUS
Seniority level
  • Not Applicable
Employment type
  • Full-time
Job function
  • Health Care Provider
  • Hospitals and Health Care
#J-18808-Ljbffr

  • Outpatient Coding Quality Auditor

    4 weeks ago

    Taguig, Philippines Conifer Health Solutions Full time

    Outpatient Coding Quality Auditor Conifer Health Solutions is seeking the Auditor, Coding Quality to conduct Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient, and profee claims, ICD-10-CM/PCS, and/or CPT codes were...

  • Outpatient Coding Quality Auditor

    1 week ago

    Taguig, Philippines Tenet Global Business Center, Inc. Full time

    The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally recognized coding...

  • Outpatient Coding Quality Auditor

    2 weeks ago

    Taguig, National Capital Region, Philippines Tenet Global Business Center, Inc. Full time ₱1,200,000 - ₱2,400,000 per year

    The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally recognized coding...

  • Inpatient Coding Quality Auditor

    5 days ago

    Taguig, Philippines Conifer Health Solutions Full time

    Sr. Recruitment Analyst | Psychometrician Job Description: The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and...

  • Inpatient Coding Quality Auditor

    4 weeks ago

    Taguig, Philippines Conifer Health Solutions Full time

    Overview Inpatient Coding Quality Auditor role at Conifer Health Solutions. The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits to ensure hospital inpatient, outpatient, and profee claims, ICD-10-CM/PCS, and/or CPT codes are coded and...

  • Quality Auditor-Medical Coding Surgery

    7 days ago

    Taguig, National Capital Region, Philippines Spanex IT Services Full time ₱900,000 - ₱1,200,000 per year

    URGENTLY HIRINGQuality Auditor - Medical Coding SurgerySurgical Coding Expert (CPT 1-6 series) with deep knowledge of Implant Billing (Cardiac, Ortho, Neuro, etc.).Skilled in coding Endoscopies and L&D (Vaginal/C-Section).Experience with Charge Audits for implants, supplies (HCPCS), meds, and Recovery Room (Rev 710).Proficient in 1&I...

  • Inpatient Coding Quality Specialist

    2 weeks ago

    Taguig, National Capital Region, Philippines Tenet Global Business Center, Inc. Full time $104,000 - $130,878 per year

    Job Description:The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally...

  • Quality Auditor

    7 days ago

    Taguig, National Capital Region, Philippines Spanex IT Services Full time ₱900,000 - ₱1,200,000 per year

    Quality Auditor - Medical Coding SurgerySurgical Coding Expert (CPT 1-6 series) with deep knowledge of Implant Billing (Cardiac, Ortho, Neuro, etc.).Skilled in coding Endoscopies and L&D (Vaginal/C-Section).Experience with Charge Audits for implants, supplies (HCPCS), meds, and Recovery Room (Rev 710).Proficient in 1&I (Infusion/Injection/Hydration),...

  • Outpatient ED Coder

    1 week ago

    Taguig, National Capital Region, Philippines CPS Asia Pacific Full time ₱85,000 - ₱100,000 per year

    We're Hiring: Outpatient ED Coder - Team Lead (PRN + OP)Lead a team of skilled coders and ensure coding accuracy, quality, and compliance in the Outpatient Emergency Department setting. Join our dynamic and supportive healthcare team today Position: Outpatient ED Coder - Team Lead Setup: 100% Work From Home (TWFH) Type: Non-Voice | PRN + OP Salary Range: PHP...

  • Outpatient Medical Coder

    4 weeks ago

    Taguig, Philippines KMC Solutions Full time

    Job Title and Location JOB TITLE: OUTPATIENT MEDICAL CODER LOCATION: BGC, TAGUIG Job Overview Day Shift Onsite at Taguig 1–3 years of experience in Outpatient Facility Coding, specifically with Injection and Infusion services Responsibilities Analyze medical records, physician notes, and other documentation to identify billable services and...