AAPC/AHIMA Certified Medical Coder Job at Clarus RCM (Pasig City)

New

Senior Quality Analyst

We’re building a world of health around every individual — shaping a more connec...

Location

United States

Salary:

46988.00 - 112200.00 USD / Year

CVS Health

Expiration Date

March 20, 2026

Requirements

Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required
Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 5 years for CPC
CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
CPMA (Certified Professional Medical Auditor) or CDEO (Certified Documentation Expert Outpatient) preferred
Experience with International Classification of Disease (ICD) codes required
Expertise in medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines
Bachelor's degree preferred specialized training/relevant professional qualification, or equivalent work experience

Job Responsibility

Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures
Contributes to compliance reporting and documentation, highlighting findings, recommendations, and areas of concern to be delivered to coding resources
Demonstrated ability to apply coding judgment and make decisions using industry-standard evidence and tools, exercising independent judgment to determine final outcomes prior to submission with minimal supervision
Adhere to stringent timelines consistent with project deadlines and directives
Demonstrates a strong commitment to enhancing and promoting quality
consistently delivers accurate and thorough work, and supports others in achieving the same standards through effective mentoring and instruction
Serves as the training resource and subject matter expert to vendors, providers and other team members for questions regarding ICD coding and documentation requirements
Comprehensive knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity
Identify and communicate documentation deficiencies to allow for continuous education opportunities for providers, vendors and peers
Expertise in medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines

What we offer

Affordable medical plan options
a 401(k) plan (including matching company contributions)
an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Fulltime

New

Coding Data Quality Auditor

We’re building a world of health around every individual — shaping a more connec...

Location

United States

Salary:

18.50 - 38.82 USD / Hour

CVS Health

Expiration Date

March 31, 2026

Requirements

Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 1-2 years for CPC
CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required
CRC (Certified Risk Adjustment Coder) or obtain within 6 months
Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)
Experience with International Classification of Disease (ICD) codes required
Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred
AA/AS or equivalent experience

Job Responsibility

Perform audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures
Support coding judgment and decisions using industry standard evidence and tools
Abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting
Establish medical necessity
Identify clinically active vs. historical conditions
Ensure diagnosis codes are appropriate, accurate, and supported by clinical documentation
Utilize medical records to ensure support is documented for etiology and manifestations of disease processes
Adhere to stringent timelines consistent with project deadlines and directives
Conduct self- process audits to ensure compliance with internal policies and procedures as well as regulatory guidance from CMS, OIG or other Regulatory body

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Fulltime

New

Analyst, Coding Data Quality Auditor

We’re building a world of health around every individual — shaping a more connec...

Location

United States

Salary:

21.10 - 44.99 USD / Hour

CVS Health

Expiration Date

March 13, 2026

Requirements

Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)
Experience with International Classification of Disease (ICD) codes required
5 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required
CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
Bachelor of Arts/ Bachelor of Science Degree or equivalent experience
Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 3 years for CPC
5-8 years encompassing additional credentials and/or application of credentials

Job Responsibility

Responsible for performing quality inter-rater review audits of medical records coded by internal team (CDQA and Sr CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures
Proven ability to support coding judgment and decisions using industry standard evidence and tools
Ability to confidently speak to such evidence across stakeholders with varying knowledge and clinical expertise in either written or verbal forms including communication with clinical or coding staff, federal regulators and vendor coding resources
Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations
Ability to work independently as well as in a cross functional role within other teams for collaboration on best practices
Possesses a genuine interest in improving and promoting quality
demonstrates accuracy and thoroughness and assists others to achieve the same through mentoring and instruction
Conducts process audits to ensure compliance with internal policies and procedures as well as regulatory guidance from CMS, OIG or other Regulatory body
Expertise in assigning accurate medical codes for diagnoses as documented for physicians and other qualified healthcare providers in the office and/or facility setting
Thorough knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity

What we offer

Affordable medical plan options
a 401(k) plan (including matching company contributions)
an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Fulltime

!

New

Coding Data Quality Auditor, Analyst

Responsible for performing quality inter-rater review audits of medical records ...

Location

United States

Salary:

21.10 - 44.99 USD / Hour

CVS Health

Expiration Date

March 27, 2026

Requirements

CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
Experience with International Classification of Disease (ICD) codes required
Minimum of 3 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required
Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)
BA/BS or equivalent experience
Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 3 years for CPC
5-8 years encompassing additional credentials and/or application of credentials

Job Responsibility

Perform quality inter-rater review audits of medical records coded by internal team
Ensure ICD-10 codes submitted to CMS for risk adjustment are appropriate, accurate, and supported
Support coding judgment using industry standard evidence and tools
Communicate evidence across stakeholders
Lead dispute resolution
Mentor and provide education to internal staff based on audit findings
Communicate audit process and results to appropriate departments and management
Conduct process audits to ensure compliance
Identify and recommend opportunities for process improvements
Work independently and in cross functional teams

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
No-cost tobacco cessation programs
No-cost weight management programs
Confidential counseling
Financial coaching
Paid time off
Flexible work schedules

Fulltime

New

German-speaking sourcing recruiter

Randstad Sourceright is a global talent leader, providing solutions and expertis...

Location

Hungary , Budapest

Salary:

Not provided

Randstad

Expiration Date

May 31, 2026

Requirements

Professional fluency in German and English is required
1+ years of sourcing/recruitment experience
Have an autonomous, proactive, and self motivated attitude
Good stakeholder management and communication skills
Experience working on high-volume projects and campaigns
Motivation and willingness to learn and tackle challenges

Job Responsibility

Conducting intake/briefing calls - collaborate with the Hiring Managers and Talent Advisors to understand the requirements of each open role
Source & screen for the best talent & find the best - able to adapt sourcing techniques to different roles and be able to source using various channels
Work very closely with Talent advisors to find the best candidates for the open positions
Conducting phone or video screening calls
Interact with candidates and focus on providing a great candidate experience at every opportunity
Attending weekly calls/catch ups with the hiring managers to share updates regarding the sourcing process

What we offer

Base salary with quarterly bonus, supplemented by a comprehensive benefits package (medical care, psychological support, sports card, shared purchase plan, and more)
A world-class experience and learning opportunities, with fantastic opportunities for career development and personal growth (around 3 different paths you can follow)
An inspiring and multicultural working environment in which you, together with your team and colleagues, will make a difference for our customers
Participate in exciting Team Building events

Fulltime

New

Talent advisor

Randstad Enterprise provides solutions and expertise that help companies positio...

Location

Hungary , Budapest

Salary:

Not provided

Randstad

Expiration Date

May 31, 2026

Requirements

Professional fluency in Portuguese and English is essential
Proven experience in IT/Technical recruitment
Ability to influence senior leadership and provide a high-touch, "white-glove" recruitment service
Strong critical thinking skills and the ability to navigate complex hiring landscapes across different geographies

Job Responsibility

Manage the recruitment process for high-volume and niche tech vacancies
Act as a consultative partner to hiring managers and senior stakeholders, providing data-driven insights and recruitment advice
Hire top-tier tech talent across EMEA, utilizing your linguistic skills to penetrate the Portuguese-speaking market
Ensure a high-class standard of client experience, tailoring recruitment solutions based on specific technical requirements
Utilize advanced sourcing tools, AI technology, and CRM insights to identify passive talent

What we offer

Supportive leadership that prioritises your well-being and personal development
Access to internal career opportunities, international mobility, and a fully flexible working environment
A culture of belonging where we value the diversity our people bring to our workplace and communities

New

Italian speaking first line analyst

First Line Analysts aka Service Desk Agents as the members of a first line custo...

Location

Hungary , Budapest

Salary:

Not provided

Randstad

Expiration Date

March 20, 2026

Requirements

Intermediate knowledge in English
Fluency in Italian
Affinity to resolve IT related issues
Daily computer use, knowledge of Windows 7, 8, 10 and/or other operating systems, MS Office tools
Logical thinking and solving problems fast and resourcefully
Outstanding communication skills and customer focused mind-set
Ability to do multitasking
Enjoy working in a team

Job Responsibility

Answering support queries via tools, phone and email, keeping daily contact with our users calling from all over Europe
Resolving IT issues of our partners which can occur during the course of office work
Documentation and logging of calls on the ticketing tool
Delegation of problems which cannot be resolved on first level to the competent teams
Maintaining and improving customer satisfaction level

What we offer

Cafeteria
Medicare
Private health care package
Home office opportunity
Training and talent program opportunities
Fun and diverse atmosphere

Fulltime

New

Primary teacher

Temp Primary Teacher - Bristol & Surrounding Areas. Are you a passionate and ada...

Location

United Kingdom , Bristol

Salary:

Not provided

Randstad

Expiration Date

March 25, 2026

Requirements

Qualified Teacher Status (QTS)
Experience teaching in a primary school setting
Excellent classroom management skills
Passionate about helping every child reach their full potential

Job Responsibility

Deliver High-Quality Lessons: Use provided schemes of work and resources to inspire pupils
Classroom Excellence: Maintain a well-organised, stimulating, and safe learning environment
Effective Communication: Liaise with school staff to ensure student progress and wellbeing are prioritised
Flexibility: Adapt quickly to new school settings and cultures across Bristol and North Somerset

What we offer

Paid to Scale (MPS/UPS): For roles including full planning, preparation, and assessment (PPA)
Competitive Daily Rate: For "turn up and teach" roles with zero planning or prep required
Work-Life Balance: Standard hours of 8:30 am - 3:30 pm. When the bell rings, your day is done
Supportive Environments: Work alongside collaborative teams in welcoming schools across the region
Referral Bonus
training and education
Safeguarding & Prevent

AAPC/AHIMA Certified Medical Coder

Clarus RCM

Location:
Philippines , Pasig City

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Requirements:

Nice to have:

Additional Information:

Job Posted:
December 07, 2025

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