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

Specialist SEN Support Assistant

Are you ready to be the "anchor" for a child with complex needs? Randstad Educat...

Location

United Kingdom , Crawley

Salary:

Not provided

Randstad

Expiration Date

May 25, 2026

Requirements

Background in supporting ASD, ADHD, or SEMH is essential
Level 2/3 TA qualification is preferred, but relevant experience is key
Composed during high-pressure situations
Reliable for a consistent, long-term placement

Job Responsibility

1:1 Support: Implement EHCP goals to help students reach specific developmental milestones
Behavioural Mentoring: Use de-escalation and regulation techniques to manage sensory or emotional triggers
Foster Independence: Guide students through social interactions and daily routines to build self-reliance
Personal Care: Provide dignified assistance with personal care when required

What we offer

Steady Routine: Fixed Monday-Friday hours in a single Crawley school
Professional Growth: Free specialist training, including Safeguarding and Team Teach
Real Impact: The reward of seeing long-term progress in a child's life
Referral Bonus

New

Year 5 Class Teacher

Year 5 Class Teacher | Long-Term Placement. The Opportunity: Are you a Year 5 sp...

Location

United Kingdom , East Grinstead

Salary:

Not provided

Randstad

Expiration Date

May 26, 2026

Requirements

Qualified Teacher Status (QTS)
Strong knowledge of the Year 5/6 curriculum and experience preparing students for the transition to Year 6
A team player who works effectively with TAs and the wider school community
A thorough understanding of child protection protocols and KCSiE guidelines

Job Responsibility

Plan and teach the Year 5 curriculum, with a strong focus on deepening comprehension in Literacy and fluency in Numeracy
Differentiate tasks to challenge high-achievers while providing vital support for students with SEN or EAL requirements
Implement consistent behavior management strategies to maintain a focused and positive learning environment
Regularly track pupil progress and use data to bridge learning gaps through targeted interventions

What we offer

Weekly PAYE: Transparent pay with no hidden umbrella fees
Career Growth: Access to our free CPD library, including specialized behavior management and SEND workshops
Local Insight: A dedicated consultant with expert knowledge of schools in East Grinstead and the surrounding West Sussex area
Refer-a-Friend: Earn £300 in vouchers for every teacher you refer to us

New

Specialist SEN Support Assistant

Are you ready to be the "anchor" for a child with complex needs? Randstad Educat...

Location

United Kingdom , Crawley

Salary:

Not provided

Randstad

Expiration Date

May 25, 2026

Requirements

Background in supporting ASD, ADHD, or SEMH is essential
Level 2/3 TA qualification is preferred, but relevant experience is key
Experience in supporting learners with Autism (ASD), ADHD, and SEMH needs
Composed and resilient
Reliable and looking for a consistent, long-term placement

Job Responsibility

1:1 Support: Implement EHCP goals to help students reach specific developmental milestones
Behavioural Mentoring: Use de-escalation and regulation techniques to manage sensory or emotional triggers
Foster Independence: Guide students through social interactions and daily routines to build self-reliance
Personal Care: Provide dignified assistance with personal care when required

What we offer

Steady Routine: Fixed Monday-Friday hours in a single Crawley school
Professional Growth: Free specialist training, including Safeguarding and Team Teach
Real Impact: The reward of seeing long-term progress in a child's life
Referral Bonus

New

Primary Teaching Assistant

Are you a compassionate and driven individual dedicated to helping young learner...

Location

United Kingdom , Crawley

Salary:

Not provided

Randstad

Expiration Date

May 26, 2026

Requirements

Proven experience in working with children (Primary school experience is a major plus)
A patient, adaptable, and nurturing approach to student support
Effective communication and ability to collaborate with teachers and build rapport with pupils
A dedicated focus on child safety (An enhanced DBS check is required)

Job Responsibility

Break down complex teacher instructions into manageable steps for students
Provide focused 1:1 or small group attention to pupils who require extra help
Support students with diverse learning requirements (ASD, ADHD, SEMH) to ensure they are fully included
Prepare creative learning resources
Ensure the classroom remains an organized, welcoming space

What we offer

Competitive Pay
Work-Life Balance (term-time-only schedule)
Professional Growth (access to tailored training and CPD opportunities)
Local Network (collaborative community of schools across West Sussex)
Referral Bonus

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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