Certified Medical Coder Job at Clarus RCM (Pasig, Manila)

AAPC/AHIMA Certified Medical Coder

We are looking for AAPC/AHIMA certified medical coders for our Philippine locati...

Location

Philippines , Pasig City

Salary:

30000.00 - 35000.00 PHP / Month

Clarus RCM

Expiration Date

Until further notice

Requirements

Registered or accredited by the (American Health Information Management Association AHIMA) or AAPC
Should have experience in coding&Denial Management
Should have good English communication skill
Candidate should have prior experience in working claims and denials for hospital or physician side
Ability to write appeals to the insurance company

What we offer

Paid leaves
HMO
For those who can join within 2 weeks, a one-time joining bonus of 5,000 Pesos

Fulltime

Senior Billing & Coding Compliance Consultant

Our client is seeking a Senior Billing & Coding Compliance Consultant to serve a...

Location

United States , Dallas

Salary:

Not provided

Medasource

Expiration Date

Until further notice

Requirements

High School Diploma or equivalent and six (6) years of experience in a professional billing environment with emphasis on coding, auditing, and/or compliance responsibilities
Certification as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Medical Coder (CMC) required
Must obtain Certified Professional Medical Auditor (CPMA) certification within 12 months of hire
Strong knowledge of CPT, HCPCS, and ICD-9-CM coding systems, medical record documentation standards, and accepted billing/coding standards
Ability to analyze medical records, billing history, payer rules, and other data to validate regulatory compliance and organizational billing integrity
Experience developing and conducting coding and compliance training and presentations for individuals and groups
Strong verbal and written communication skills
Ability to work independently and collaboratively as a team member
Proficiency in Microsoft Office (Word, Excel, PowerPoint)
Detail-oriented with strong organizational and prioritization skills

Job Responsibility

Serve as a billing integrity project leader for all service lines, developing and conducting individual or group presentations on coding, billing, and compliance topics
Develop and deliver standardized and specialty-driven coding and compliance training (“onboarding”) for new providers
Perform post-onboarding pre-bill reviews of professional charges for any service line
Assist in ensuring pending charges are reviewed and released in a timely manner
Independently review the adequacy of medical record documentation to support procedure, modifier, and diagnosis coding, identify compliance risks, and develop recommended solutions or action plans
Summarize findings and develop action plans for risk mitigation
Research and respond to coding, documentation, and reimbursement policy questions or problems
Support and/or conduct risk-based billing compliance audits and provide resulting education in coordination with the Compliance Office
Complete charge review and follow-up Epic work queue assignments for any service line
Provide training to new internal or contractor staff on audit software, Epic, audit plans, and work queue assignments

What we offer

Competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage
401k plan with company match
Paid time off, sick time, and paid company holidays
Employee Assistance Program (EAP) providing services like virtual counseling, financial services, legal services, life coaching

Risk Adjustment Education Specialist

This Job will report to the Risk Adjustment Manager of Coding Operations. Respon...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Associate degree or equivalent experience required
5 years of experience in a hospital, a physician setting, or a Managed Care Organization as a medical coder required
2 years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding) required
Other experience in teaching, training, or an educator/instructor role is needed
Must have experience in creating effective training materials and presentations (PowerPoint, Adobe, etc.)
Certified Professional Coder (CPC) from AAPC is required
Certified Risk Adjustment Coder (CRC) from AAPC is preferred
An RN or LVN must obtain both CPC and CRC within 12 months of hire
Must be proficient in Prospective, Retrospective, and Concurrent review processes
Must have strong clinical knowledge of disease pathology and ability to identify clinical indicators related to chronic disease

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Subject matter experts for proper risk adjustment coding and CMS data validation
Work in conjunction with other departments, including Provider Relations, Quality, and the Medical Director, to ensure compliance with CMS risk adjustment guidelines
Analyze MRA data to identify patterns and development of provider and market-level interventions to coordinate an educational work plan for providers
Conduct provider education and training regarding risk adjustment to help ensure accurate CMS payment and improve care quality
This includes training venues such as provider offices, hospitals, webinars, conference calls, email correspondence, etc
Responsible for building positive relationships with assigned Physicians and serving as a contact for any questions or concerns that may arise
Identify those Practices that need initial or ongoing additional training
Perform other duties as necessary

Fulltime

Payment Integrity Coding Coordinator

The Coding Coordinator is responsible for performing audit activities in the are...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 years of experience of professional/physician, inpatient, diagnostic and procedural coding, claims administration, claims auditing or related experience required
High-School Diploma or GED in general field of study
Certified Professional Coder (CPC), or Certified Inpatient Coder (CIC)
Intermediate skill in use of office equipment
Intermediate PC proficiency
Intermediate proficiency in spreadsheet and word processing software
Basic skill in mathematics
Knowledge of medical terminology, ICD-10 CM & PCS, CPT and DRG codes
Ability to read, analyze, and interpret technical procedures, medical reports, fee schedules and medical coverage guidelines
Broad understanding of health insurance terms and concepts

Job Responsibility

Perform audit activities in the areas of data mining, contract compliance, itemized bill reviews and provider outreach/education for all claim types to validate correct claims coding and billing practices
Identify and correct abusive and wasteful billing and coding practices by conducting pre and post-payment coding compliance audits
Communicate recommended solutions, and facilitating corrections, recovery of overpayments and provide education to promote correct, accurate and consistent coding and billing practices among providers
Through data analysis, identify areas of high risk for coding and billing variances
Collaborate with analyst to define reporting criteria to evaluate shifts in utilization and provider coding patterns
Interprets data, draws conclusions, and reviews findings with all levels within the organization
Conducts audits of claims by selecting claims that have been identified as in scope for audit
Audits claims, medical records and corresponding documentation for appropriate coding
Applies knowledge of medical coding, diagnostic-related group (DRG) and current coding guidelines
Performs hospital charge audits and itemized bill audits on all high dollar claims and as needed on other questionable charges applicable to outpatient/professional services

Fulltime

Management Trainee – Operations (Medical Coding Trainer)

We are seeking an experienced and certified Medical Coding Trainer to facilitate...

Location

India , Chennai

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Excellent communication and people skills
Strong analytical skills and in-depth knowledge of the Revenue Cycle Management (RCM) cycle
Minimum 5 years of work experience
3 to 4 years in medical coding
1 year in denial coding management
1 year in trainer role
Proven experience in a training role within Medical Coding or a related field
Experience in training and mentoring coders
AHIMA/AAPC certified
Expertise in medical coding using ICD-10-CM, CPT conventions, and HCPCS codes

Job Responsibility

Follow the training agenda and facilitate the training sessions for Coding – Denial Management
Utilize proficient analytic skills to accurately code medical records using ICD-10-CM, CPT conventions, and HCPCS codes
Browse payer guidelines to collate and provide the most accurate payer-specific information
Interpret medical records across various specialties and provide appropriate denial actions based on analysis
Handle and train diverse groups of new hires and existing coders
Mentor and develop coders' capabilities in denial management within the organization
Provide Subject Matter Expert (SME) support for transitioning clients
Conduct focus and compliance audits for all types of coders and auditors (ATA)
Report and analyze trainees' performance to ensure client partners are ramping up to meet client and SD/SQ team standards

New

Compliance Coordinator

This position is accountable for collaborating with and assisting the Valley Chi...

Location

United States , Madera

Salary:

38.25 - 56.60 USD / Hour

Valley Children's Healthcare

Expiration Date

Until further notice

Requirements

High School Diploma/G.E.D. (required)
College Degree - 4 year Healthcare related field (preferred)
CPC - Certified Professional Coder - AAPC - American Academy of Professional Coders (required)
CPMA - Certified Professional Medical Auditor - AAPC - American Academy of Professional Coders within 18 months of hire or transfer into position (required)
Minimum four (4) years Experience in a healthcare environment (required)
Experience with researching, evaluating, interpreting and tracking changes in laws, regulations and guidelines and implementing changes in policies and procedures. (required)
Experience with Medi-Cal and commercial payer guidelines preferred, particularly Evaluation and Management. (preferred)
Experience with hospital (facility) coding and billing (preferred)
Public speaking skills highly recommended.
Must have excellent verbal and written communication skills and able to communicate effectively providing verbal feedback in a professional manner.

Job Responsibility

Collaborating with and assisting the Valley Children's Healthcare Corporate Compliance Officer and the Compliance Manager with the development, implementation and facilitation of comprehensive healthcare corporate compliance, risk management and creating and performing improvement programs and compliance training for Valley Children's Healthcare professional service providers.
Provides content expertise with organization of projects and teams, statistical reports, and analyzing medical records for completeness, timeliness and accuracy.
Plans, organizes and implements the monitoring, evaluation and continuous improvement activities and works collaboratively to facilitate the organizational goals, mission and corporate culture of Valley Children's Healthcare.

Fulltime

Trainer - Medical Coding

We are hiring a Trainer - Medical Coding with 3+ years of experience to join our...

Location

India , Chennai

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Certified coder from AAPC or AHIMA
Strong analytical skills
Hands-on experience in HCC coding and denial management
Excellent team management and communication skills
Knowledge of the RCM cycle
Minimum 3 years of work experience in training for HCC coding
Good analytic skills and expertise to be proficient in accurately coding medical records utilizing ICD-10-CM, CPT conventions & HCPCS codes
Hands on experience in HCC coding, training and mentoring coders for developing capability on denial management in the organization

Job Responsibility

Follow the training agenda and facilitate the training for HCC Coding
Browse payer guidelines and collate the most accurate information with payer specifics
Interpret medical records of patients in different specialties and able to provide appropriate denial actions for the analysis done
Provide continuous education for given set of clients
Assist in compliance audits internally for all types of HCC coders and auditors
Keep in pace with industry changes in medical coding domain
Report and analyse the trainees and make the client partners ramp up to the speed of the Client and SD/SQ teams

Client Partner

Location

India , Noida

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Minimum 1 to 4 years of experience in IPDRG medical coding -US Healthcare
Any Graduate
associate’s degree in health information management, Medical Coding, or a related field preferred
Specialization: Inpatient DRG
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.

Job Responsibility

Assign DRG Codes: Accurately assign DRG codes to inpatient records using ICD-10- CM/PCS coding systems based on clinical documentation and physician notes. Ensure codes reflect the correct diagnosis, procedures, and the overall complexity of care.
Clinical Documentation Review: Review and analyze medical records to verify diagnoses, procedures, and treatments. Work with physicians and healthcare providers to clarify and improve clinical documentation when needed for proper coding.
DRG Assignment: Utilize the DRG methodology to ensure accurate and consistent DRG assignment based on the severity of illness (SOI) and risk of mortality (ROM), among other factors. Apply coding conventions and guidelines as per CMS (Centers for Medicare & Medicaid Services) and payer requirements.
Continuous Education: Keep up to date with coding guidelines, coding technology, and industry changes related to DRGs, including changes in ICD-10-CM/PCS, federal regulations, and insurance payer policies.
Billing Support: Work closely with the billing department to resolve coding issues and ensure that all claims are processed correctly and promptly for reimbursement. Ensure timely submission of all inpatient claims for accurate payment processing

Certified Medical Coder

Clarus RCM

Location:
Philippines , Pasig, Manila

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
December 07, 2025

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