Risk Adjustment Coder

4 days ago


Taguig, National Capital Region, Philippines UST Full time ₱288,000 - ₱432,000 per year

Role Description

  • Assign appropriate ICD-10-CM codes, mapping to risk adjustment models for Medicare Advantage and ACA Commercial Projects.
  • Assign Flag events and CDI for documentation discrepancies.
  • Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines.
  • Comply with HIPAA laws and regulations.
  • Maintain quality (≥97%) and production standards.
  • Remain current on diagnosis and coding guidelines and risk adjustment reimbursement reporting requirements.
  • Utilization Review

Additional Requirements

  • Night shift is mandatory
  • This is a full-time, in-office role with 5 working days per week
  • Candidates must demonstrate alignment with UST's core values: Humility, Humanity, and Integrity

Qualifications

  • At least 2+ years of medical coding experience (HCC Risk Adjustment)
  • USRN – Active license
  • Experienced Utilization Management Reviewer
  • Experienced in the application of guidelines and processes in UM Reviews
  • Active coding certification under AAPC or AHIMA; Certified Risk Adjustment Coding (CRC) certification preferred
  • Able to code using ICD-10-CM physical codebook or coding software
  • Strong clinical knowledge related to chronic illness diagnosis, treatment, and management
  • Proficient in using computers, including MS Office and internet applications

Skills
Medical Coding, USRN, ICD,HCC



  • Taguig, National Capital Region, Philippines ATOS Information Technology Inc. Full time ₱900,000 - ₱1,200,000 per year

    Shift Schedule: Mid shiftWork Setup: Fully RemoteJob Summary:We are seeking newly certified coders to join our team. The ideal candidate will be responsible for reviewing medical records to identify, code, and validate diagnoses based on risk adjustment models such as HCC (Hierarchical Condition Categories). The coder must ensure accuracy, compliance, and...


  • Taguig, National Capital Region, Philippines Atos Full time ₱400,000 - ₱1,200,000 per year

    Shift Schedule:Night shift during training, then mid shift afterward.Work Setup:Fully onsite during training, then remote afterward.Job Summary:We are seeking newly certified coders to join our team. The ideal candidate will be responsible for reviewing medical records to identify, code, and validate diagnoses based on risk adjustment models such as HCC...


  • Taguig, National Capital Region, Philippines UST Full time $40,000 - $60,000 per year

    Assign appropriate ICD-10-CM codes, mapping to risk adjustment models for Medicare Advantage and ACA Commercial Projects.Assign Flag events and CDI for documentation discrepancies.Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelinesComply with HIPAA laws...


  • Taguig, National Capital Region, Philippines Conifer Health Solutions Full time ₱300,000 - ₱450,000 per year

    Conifer Global Business Center Inc. is hiring outpatient medical coders who are ready to advance their careers by training in inpatient medical coding through our Coding University.What's in it for you?We have a team of highly experienced and skilled professionals to help and provide you with comprehensive training and grow a promising career in the Medical...


  • Taguig, National Capital Region, Philippines Shearwater CPO® - Home of Clinicians Full time ₱900,000 - ₱1,200,000 per year

    Required:• Required Certification: PHRN, CPC/CRC• Minimum 3 years in RA Coding• At least 1 year in coding quality role• At least 2 years in the hospital setting• Course Graduated: BS in NursingDesired:• Good communication skills and analytical skills• Strict focus on coding, education, and quality assurance• Strong experience in roles that...


  • Taguig, National Capital Region, Philippines RCBC Full time

    Job SummaryThe Quantitative Risk Officer supports the Chief Sustainability Officer in tasks requiring quantitative skills and/or involving finance theory issues. These tasks are focused on model performance assessments, stress testing, and quantitative regulatory requirements that help ensure sound risk management monitoring and compliance with capital...


  • Taguig, National Capital Region, Philippines RCBC Full time $104,000 - $130,878 per year

    Job Summary:The Quantitative Risk Officer supports the Chief Sustainability Officer in tasks requiring quantitative skills and/or involving finance theory issues. These tasks are focused on model performance assessments, stress testing, and quantitative regulatory requirements that help ensure sound risk management monitoring and compliance with capital...


  • Taguig, National Capital Region, Philippines IGO Digital High Technology, Inc. Full time ₱25,000 - ₱28,000 per year

    Qualification:Must have experience in processing and verifying withdrawals or deposits.- Prior experience in the gaming, betting, or financial industries is preferred.Applicants with a background in data analysis, customer service, finance, or similar fields will be prioritized.Ability to analyze data and identify potential risks.Experience in conducting...


  • Taguig, National Capital Region, Philippines Tenet Global Business Center, Inc. Full time ₱80,000 - ₱150,000 per year

    Job SummaryWe are Urgent hiring for certified medical coders to start on October 13, 2025, who are ready to advance their careers by training in inpatient medical coding through our Coding University. Our goal is to help you pass and earn your Medical Coding certification (CIC) through our Coding University.Job requirements:Must have an active Medical Coding...


  • Taguig, National Capital Region, Philippines BHP Full time $150,000 - $200,000 per year

    About BHPAt BHP we support our people to grow, learn, develop their skills and reach their potential. With a global portfolio of operations, we offer a diverse and inclusive environment with extraordinary career opportunities. Our strategy is to focus on creating a safe work environment where our employees feel strongly connected to our values and...