Medical Coder

Medical Coder

REPORTING: Manager, Clinical Auditing Services- Philippines Medical Coder are responsible for applying clinical and/or medical coding knowledge in the review of evidentiary documentation in medical records.  This position requires the ability to perform accurate and complete diagnostic coding, abstraction of pharmaceutical studies, HEDIS medical records reviews, and other related duties in a high quality and production environment. SUMMARY OF RESPONSIBILITIES: Medical Coding assignments may include work from all lines of Company’s business (e.g., diagnostic auditing, HEDIS reviews, drug safety/efficacy studies). Each assignment will have specific requirements and timelines.  Diagnostic Coding: Medical Coder review assigned medical records and apply appropriate diagnostic codes and modifiers according to Generally Accepted Medical Coding Guidelines, ICD-9 Guidelines and CMS Correct Coding Initiatives, coding guidelines approved by CMS, and all rules, regulations and guidelines promulgated by CMS and applicable to contractors and subcontractors of CMS-approved sponsors (collectively the “Standards”), all as reasonably interpreted by the Company. HEDIS Reviews: Medical Coder review assigned medical records and document measure specific clinical data according to NCQA technical specifications for hybrid medical records reviews. Health Outcomes Studies: Medical Coder review assigned medical records and document relevant clinical data according to stated study objectives. Requirements: At least 1 year of professional nursing experience Active RN license in good standing and certification from the United States based National Council Licensure Examination (NCLEX-RN) or National Philippines Nursing Accreditation equivalent Knowledge of ICD-9-CM diagnostic coding and inpatient and outpatient coding guidelines, (experience with HEDIS and CMS HCC Risk Adjustment coding and data validation is an advantage Two years experience with chart investigation, including medical coding, HEDIS, QA, Disease Management, Utilization Review or Case Management Proven ability to perform in high production environment Must be willing to work on flexible schedule including night shift Must be willing to work in The Fort, Taguig The job package consists of: Private HMO coverage Competitive Pay On top of these, MicroSourcing offers you the chance to work in a professional, international, and fun working environment where you will get the chance to meet and work with people from different parts of the world.

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