Medical Coder

3 days ago

Makati City, National Capital Region, Philippines HCM Nexus Full time ₱600,000 - ₱800,000 per year

Job Summary:

The Medical Coder is responsible for reviewing medical records and assigning appropriate diagnosis and procedure codes based on ICD-10-CM, ICD-10-PCS, CPT, and HCPCS guidelines. The role includes coding for inpatient, outpatient, or professional services, depending on business needs. Coders must ensure accurate, compliant coding for billing and reporting purposes and meet quality (95%) and productivity standards set by the company or client.

Key Responsibilities:

  • Code and abstract medical diagnoses, procedures, and treatments for inpatient, outpatient, or day surgery cases.
  • Review provider documentation to identify principal diagnoses, co-morbidities, and performed procedures.

  • Assign appropriate codes and classifications:

  • Inpatient: ICD-10-CM, ICD-10-PCS, Present on Admission (POA), DRG, CC/MCC.

  • Outpatient/Professional: ICD-10-CM, CPT, HCPCS, APC.
  • Follow official coding guidelines and client-specific instructions.
  • Submit queries to providers for clarification or improvement of documentation.
  • Enter coding data into systems (encoder and abstracting tools).
  • Report daily productivity and any issues to the supervisor.
  • Flag and report improper coding or documentation issues.
  • Maintain strict patient confidentiality.

Qualifications:

Knowledge & Skills:

Proficient in coding systems and guidelines (ICD-10, CPT, HCPCS, DRG, APC).

Skilled in using encoder tools and computer applications.

Strong analytical and communication skills.

Fluent in English.

Education:

Bachelor's degree in Medical Records or Allied Medical Field, or equivalent work experience.

Experience:

At least 1 year of coding experience in an acute care, clinic, or ED setting (6 months on live accounts).

Certifications:

AAPC: CPC, COC, CIC

AHIMA: CCA, CCS-P, CCS

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