Outpatient Medical Coder QA

23 hours ago

Quezon City, National Capital Region, Philippines Private Advertiser Full time

We are looking to hire experienced Outpatient Medical Coder QAs with coding certifications in a remote set-up

MUST have requirements

  • At least 5 years of Medical Coding for Outpatient facility settings
  • Has exposure to multiple specialties (Coding and Auditing for Same Day Surgery, Observation, and ED).
  • Preferably in Ancillary, Clinic, or E/M experience
  • Has and maintains at least 1 role-related certification (CPC / COC / CCS / CCS-P if OP role / CPMA if auditor role)

Responsibilities

  • Conduct audits in various medical coding specialties in inpatient settings to assess coding accuracy and ensure adherence to official coding guidelines.
  • Provide detailed rationale and supporting references for recommendations and findings.
  • Utilize industry-recognized references to support review findings, such as the ICD-10-CM Official Guidelines for Coding and Reporting.
  • Identify coding error trends across multiple specialties to aid in root cause analysis.
  • Stay current with updates in medical coding guidelines, payer-specific requirements, and client-specific requirements.
  • Prepare and present reports summarizing audit findings and error trends.
  • Identify smart observations for process improvements with quantifiable business impact.

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