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Medical Coding Expert

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Cebu City, Central Visayas, Philippines Health Business Solutions Full time
Job Description:

The Coding Auditor will play a critical role in ensuring the accuracy and compliance of medical coding practices within our organization. This individual will perform detailed reviews of medical documentation and coding, guaranteeing adherence to regulatory standards such as ICD-10, CPT, and HCPCS.

This position requires strong analytical skills to identify errors and discrepancies in coding practices, as well as excellent communication skills to provide feedback and education to coding teams and healthcare providers.

The ideal candidate will have certifications in medical coding, such as CPC, CCS, or CIC, and experience working with risk adjustment audits, clinical documentation improvement (CDI), and payer audits.

We are looking for a detail-oriented and organized individual who can analyze data and develop insights to drive improvements in coding accuracy and compliance.

  • Key Responsibilities:
  • Review and Audit Medical Records: Conduct thorough audits of medical records to ensure accurate coding and compliance with regulatory requirements.
  • Ensure Regulatory Compliance: Verify that all medical coding aligns with applicable federal, state, and local laws and regulations.
  • Identify Errors and Gaps: Detect and correct coding discrepancies, missing or incomplete documentation, and over- or under-coding issues.
  • Provide Feedback and Education: Educate coding staff and healthcare providers on accurate coding practices, documentation improvement, and regulatory changes.
  • Prepare Audit Reports: Compile detailed reports highlighting findings and recommendations for process improvement.