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

HCC Coding Auditor

The HCC Coding Auditor will perform code audits and abstractions using the Offic...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School diploma or equivalent is required
Excellent verbal and written communication skills
Minimum of 1 year of experience in hospital inpatient/outpatient settings, medical office coding, or risk adjustment coding OR 3+ years of experience in one or more of the following areas: Claims Processing, Insurance Verification, Provider Credentialing, Member Services, Member Enrollment, Medical Records Management, Health Information Management, Medical Assisting, Nursing, Billing, Benefits and Eligibility, or Provider Education
Coding certification from AAPC or AHIMA is required within six (6) months of hire: Certified Professional Coder (CPC)
Certified Professional Coder-Apprentice (CPC-A)
Certified Risk Adjustment Coder (CRC)
Certified Risk Adjustment Coder-Apprentice (CRC-A)
Certified Coding Associate (CCA)
Certified Coding Specialist (CCS)
Registered Health Information Management Technician (RHIT)

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment
Performs code abstraction and/or coding quality audits of medical records to ensure ICD-10CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS (HCC) Risk Adjustment guidelines
Performs coding quality audits within multiple EMRs, databases, and/or vendor platforms to support employed and independent clinic risk adjustment strategies
Identifies revenue, reimbursement, and provider educational opportunities while complying with state and federal regulations
Prepares and/or performs auditing analysis and provides feedback on noncompliance issues detected through auditing
Complies with all aspects of coding, abides by all ethical standards, and adheres to official coding guidelines
Provides measurable, actionable solutions to providers that will result in improved accuracy for documentation and coding practices to ensure chronic conditions are recaptured annually
Ensures that rendered physician services for claim submission and any subsequent payments are as accurate as possible while complying with regulatory guidelines, including CMS, DHS, and OIG
Assist coding leadership by making recommendations for process improvements to enhance coding quality goals and outcomes further

Fulltime

Med Records Coder III

The Med Records Coder III functions as an advanced coder in the abstraction and ...

Location

United States of America , Rochester

Salary:

21.36 - 29.90 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

HS Diploma Required
1 years’ experience as Medical Coder Required
Knowledge of ICD-10CM, CPT and HCPSC Required
Working knowledge of medical terminology and anatomy Required
Associates degree in Health Information Technology or health related field Preferred
Additional coding experience in area of assignment Preferred
Successful completion of American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) Preferred
Or Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute Preferred

Job Responsibility

Uses thorough knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign codes (ICD-10-CM, E/M, CPT, HCPCS and modifiers) through medical record documentation in accordance with universally recognized coding guidelines
Reviews and resolves coding denials
Resolves problems with claims having errors related to improper coding and provides feedback for correction and follow-up
Abstracts data and reviews codes for accuracy
Performs system edit checks and corrects errors as needed
Responds to coding information requests from various sources
Communicates document improvement opportunities and coding issues to providers, department, and/or designated leader for follow up and resolution
Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete

Fulltime

Med Records Coder III

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Albany

Salary:

21.36 - 29.90 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

HS Diploma
Associates degree in Health Information Technology or health related field (preferred)
1 years’ experience as Medical Coder
Additional coding experience in area of assignment (preferred)
or equivalent combination of education and experience
Knowledge of ICD-10CM, CPT and HCPSC required
Working knowledge of medical terminology and anatomy required
Successful completion of American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) (preferred)
Or Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute (preferred)

Job Responsibility

Functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies (e.g. ICD-10, CPT-4, HCPCS, DRG)
Analyzes, enters and manipulates database
Responds to or clarifies internal requests for medical information
Uses thorough knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign codes (ICD-10-CM, E/M, CPT, HCPCS and modifiers) through medical record documentation in accordance with universally recognized coding guidelines
Reviews and resolves coding denials
Resolves problems with claims having errors related to improper coding and provides feedback for correction and follow-up
Abstracts data and reviews codes for accuracy
Performs system edit checks and corrects errors as needed
Responds to coding information requests from various sources
Communicates document improvement opportunities and coding issues to providers, department, and/or designated leader for follow up and resolution

Fulltime

Medical Records Coder II

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Albany

Salary:

19.96 - 27.94 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

High School diploma or equivalent and less than 1 year of relevant experience required
Or equivalent combination of education and experience
Knowledge of ICD-10CM, CPT and HCPSC preferred
Working knowledge of medical terminology and anatomy preferred
American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred
Certified Professional Coder (CPC) from American Academy of Professional Coders (AAPC) or Certified Medical Coder (CMC) from Practice Management Institute preferred

Job Responsibility

Reviews system edits and assigns appropriate codes from appropriate coding classification system to ensure the production of quality healthcare data and accurate professional payment
Prepares reports for designated leader(s)
Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign appropriate codes through medical record documentation as per designated workflow
Completes system edit reviews to make corrections before transmittal
Ensures work queue and responsibilities are handled within established guidelines and timeframes
Troubleshoots problems that prevent claims from being released
Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem
Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete
Prepares reports for designated leader to document recurring problems and identifies the source of reimbursement delays
Works closely with designated leader to ensure effective communication to resolve invoice payment delays

Fulltime

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

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

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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Job Description:

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Job Posted:December 07, 2025

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