USRN - Medical Coding Assistant Manager

4 hours ago

Manila, National Capital Region, Philippines Carelon Global Solutions Full time ₱1,500,000 - ₱2,500,000 per year

Responsible for serving as the operations point of contact for Medical Management and /or Medical Coding day to day operations, including but not limited to, facilitating issue resolution, meeting goals and targets.

Primary duties may include, but are not limited to:

  • Acts as a liaison for both internal and external groups for program initiatives. Help create, launch and drive critical account initiatives and programs.
  • Provides inputs to policies and processes impacting the operations.
  • Manages a team of nurses and/or allied Healthcare professionals in the optimal execution of operations activities ensuring that each team member meets / exceeds their goals and metrics on a daily, weekly and monthly basis.
  • Coordinates with workforce for staffing requirements and scheduling of agents given leaves, absences and attrition. Prepares reports. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
  • Suggests and develops high quality, high value, concept and or process improvement and efficiency recommendations.

Qualifications

  • Registered Nurse license, either Philippines or unrestricted US territory.
  • Minimum of 2 years hospital experience and/or several years of inpatient coding experience.
  • One or more of the following certifications are preferred: Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement experience preferred.
  • Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred.

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