Outpatient Medical Coder
4 days ago
We are seeking a experienced Medical Coder to join our Revenue Integrity Team.
The ideal candidate will have a deep understanding of coding guidelines, payer policies, and compliance regulations, ensuring accurate documentation and maximized reimbursements.
Work Set-up:
WFH after training
Key Responsibilities:
Review clinical documentation to assign accurate ICD-10, CPT, and HCPCS codes.
Ensure all coding is compliant with federal, state, and payer-specific regulations.
Identify and report coding trends, documentation issues, and opportunities for process improvement.
Collaborate with auditors, providers, and billing teams to resolve coding discrepancies.
Support Revenue Integrity initiatives to enhance accuracy and optimize reimbursement.
Review accounts held for claim edits, observation edits, DNB Edits, review needed, injection & infusion edits, and revenue guardian edits generated at the time of billing.
Evaluate charges against regulatory billing rules and custom rules prior to filing the claims to the clearinghouse.
Catch possible missed revenue based on identified opportunities enabling a second level review by coders and provide resolution basis workflows defined by Ensemble.
Qualifications:
Must have active coding license
Minimum 2 years of coding experience in a healthcare BPO or hospital setting, preferably in Revenue Integrity, ED Facility, Same Day Surgery ( SDS ) or Observation Coding
Strong knowledge of ICD-10-CM, CPT, HCPCS, and medical terminology.
Familiarity with payer guidelines, claim edits, and billing processes.
Proficient in EHR/EMR systems and coding software.
Excellent attention to detail and analytical skills.
About us
access healthcare is a leading provider of healthcare services, offering a wide range of solutions to clients across the Philippines. Our mission is to improve patient outcomes by delivering high-quality, cost-effective medical services. With a dedicated team of healthcare professionals, we are committed to innovation and excellence in patient care.
Apply now for this exciting opportunity to join our team at access healthcare
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