MEDICAL CODERS WITH SOB (HCC, IP, OP, RA)

• Review and analyze medical records to assign accurate codes (ICD-10-CM, CPT, HCPCS) based on documentation.
• Ensure coding quality and accuracy in accordance with official coding guidelines, payer policies, and organizational standards.
• Validate documentation for Risk Adjustment (RA) models, including HCC coding, by identifying and capturing chronic conditions and relevant diagnoses. OR Perform coding for Inpatient and Outpatient encounters, ensuring all procedures and diagnoses are correctly captured.
• Query providers for clarifications when documentation is incomplete or ambiguous.
• Collaborate with clinical and billing teams to resolve coding and documentation discrepancies.
• Maintain coding productivity and quality standards as defined by management.
• Stay current with industry regulations, coding updates, and best practices.
• Assist with internal and external coding audits and implement corrective actions, if needed.
• Protect patient confidentiality and follow HIPAA guidelines at all times.

Qualifications:

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Risk Adjustment Coder (CRC), or equivalent credential preferred.
• Minimum 12 years of experience in medical coding, specifically in HCC, IP, OP, or RA settings.
• Strong knowledge of medical terminology, anatomy, physiology, and disease processes.
• Experience using Electronic Health Records (EHR) and coding software.
• Detail-oriented with strong analytical, communication, and organizational skills.
• Ability to work independently and meet strict deadlines.
• Must be willing to report on site in Taguig or Cubao (Wherever your nearest/ Preferred location)