Inpatient Coding Auditors Job at Clarus RCM (Pasig, Manila)

Inpatient DRG Nursing Auditor

Join our team in Manila as Inpatient DRG Nursing Auditor. If you’re a registered...

Location

Philippines , Taguig City

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Good Comprehension skills
Strong attention to detail and communication skills
Curious and willing to ask relevant questions
Ability to understand client guidelines related to insurance advantage claims
Must be Philippine Registered Nurse with Active license
Must have an experience in clinical and audit in IP DRG

Job Responsibility

Conduct initial audit reviews to validate billed diagnoses and DRG code are supported by medical records
Record audit results and document finding notes based on policies using professional clinical resources
Perform provider appeals reviews and render decision to either uphold or overturn original finding
Review questionable encoder results, complex cases, and appeal reviews to facilitate referrals to clinical department as needed
Propose new audit concepts supported by your research and analysis
Define new audit concept criteria and test and validate new concepts developed by analytics team
Escalate facility issues per client guidance

Senior Clinical Coding Auditor & Trainer

The Senior Clinical Coding Auditor & Trainer is responsible for developing, cond...

Location

United States

Salary:

Not provided

Bright Vision Technologies

Expiration Date

Until further notice

Requirements

Inpatient coding experience with active CPC, CIC, or CCS certification
Minimum 1 year of clinical experience in a hospital setting
Active nursing license (required)
Strong written and verbal English communication skills
Bachelor’s degree in Nursing or a related clinical field, or equivalent experience
4+ years of experience in nursing, training, or auditing within a managed care or healthcare setting
Prior lead or supervisory experience preferred
Current state Registered Nurse (RN) license
Valid driver’s license may be required for certain positions

Job Responsibility

Develop and maintain complex inpatient coding audit processes and tools
Conduct inpatient coding audits and review medical necessity guidelines
Design and deliver clinical coding education for new and existing staff
Identify training needs and develop appropriate learning materials and aids
Audit staff performance, identify errors, and collaborate on corrective actions
Present audit findings and improvement recommendations to leadership
Evaluate training effectiveness and recommend enhancements
Research and recommend internal and external training programs
Maintain detailed records of training activities and employee progress
Assist with policy, procedure, and workflow revisions related to inpatient coding

Fulltime

New

Inpatient/DRG Validation Coding Auditor

The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute i...

Location

United States , Sharonville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

5+ years inpatient coding experience
3+ years facility coding audit experience (DRG/APC validation)
Strong knowledge of reimbursement methodologies and DRG payment systems
Proficiency in EMRs, encoders, proprietary audit systems, and Microsoft Office
Deep understanding of HIPAA and confidentiality requirements
Strong analytical, written, and verbal communication skills
Solid grasp of medical and surgical terminology
Bachelor’s Degree or equivalent experience
Required certification (CCS preferred): CPC (Certified Professional Coder)
CCS (Certified Coding Specialist)

Job Responsibility

Perform detailed audits of inpatient records to validate ICD-10-CM/PCS coding, DRG assignment (MS-DRG, APR-DRG, TRICARE), and clinical documentation accuracy
Ensure documentation supports coded diagnoses, procedures, severity of illness, and resource utilization
Identify overpayments and underpayments through claim analysis (including 30-day lookbacks)
Provide clear, compliant audit recommendations aligned with Official Coding Guidelines and AHA Coding Clinics
Partner with CDI specialists to identify documentation improvement and query opportunities
Maintain productivity, quality standards, and client turnaround expectations
Stay current on regulatory changes, reimbursement policies, and coding updates
Contribute to process improvement initiatives and compliance risk identification

What we offer

medical
vision
dental
life and disability insurance
company 401(k) plan

DRG Validation Coding Auditor

The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute i...

Location

United States , Cincinnati

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

5+ years inpatient coding experience
3+ years facility coding audit experience (DRG/APC validation)
Strong knowledge of reimbursement methodologies and DRG payment systems
Proficiency in EMRs, encoders, proprietary audit systems, and Microsoft Office
Deep understanding of HIPAA and confidentiality requirements
Strong analytical, written, and verbal communication skills
Solid grasp of medical and surgical terminology
Bachelor’s Degree or equivalent experience
Required certification (CCS preferred): CPC (Certified Professional Coder)
CCS (Certified Coding Specialist)

Job Responsibility

Perform detailed audits of inpatient records to validate ICD-10-CM/PCS coding, DRG assignment (MS-DRG, APR-DRG, TRICARE), and clinical documentation accuracy
Ensure documentation supports coded diagnoses, procedures, severity of illness, and resource utilization
Identify overpayments and underpayments through claim analysis (including 30-day lookbacks)
Provide clear, compliant audit recommendations aligned with Official Coding Guidelines and AHA Coding Clinics
Partner with CDI specialists to identify documentation improvement and query opportunities
Maintain productivity, quality standards, and client turnaround expectations
Stay current on regulatory changes, reimbursement policies, and coding updates
Contribute to process improvement initiatives and compliance risk identification

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Medical Director of Revenue Integrity

The Physician Advisor is a key member of the healthcare organization’s leadershi...

Location

United States , Cheyenne

Salary:

Not provided

Cheyenne Regional Medical Center

Expiration Date

Until further notice

Requirements

Hold and maintain or able to obtain an unrestricted medical license in the state of Wyoming
Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety
Familiarity with InterQual and MCG is preferred
Strong understanding of Medicare Two Midnight Rules
Member of the American College of Physician Advisors (ACPA)
Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) or ACPA is required within 6 months of hire
Ability to build rapport with medical staff and hospital leadership to obtain the buy-in and collaboration necessary to achieve desired outcomes
Prefer Internal Medicine specialist with a background in Hospital Medicine
Maintain active medical practice in their specialty (Can accommodate clinical time up to 0.15 FTE in the specialty (depending on availability))
Demonstrates behavior that supports the organization’s mission

Job Responsibility

Provide functional leadership for the revenue integrity team Including CDI, Coding and Utilization Review
Responsible for oversight revenue integrity optimization
Lead value-based care initiatives for the organization
Chairs the Utilization Management Team
Review medical records of patients identified by case managers or as requested by the healthcare team including physicians to perform quality and utilization oversight
Perform medical necessity reviews including initial level of care, secondary reviews, and continued stay reviews
Conduct Peer to Peer discussion with Payor Medical Directors when requested
Provide regular feedback to physicians and all other stake holders regarding level of care, length of stay, and potential quality issues
Provide necessary clinical education to UR Case Managers regarding clinical criteria and appropriate use of screening tools
Educates individual hospital staff physicians about ICD-10 and DRG coding guidelines (e.g., co-morbid conditions, outpatient vs. inpatient) and clinical terminology to improve their understanding of severity, acuity, risk of mortality, and DRG assignments on their individual patient records

What we offer

403(b) with 4% employer match
ANCC Magnet Hospital
$10,000 relocation bonus
$3,500 in CMEs
216 hours of PTO
Robust Benefits Package

New

Healthcare Assistant & Lead Healthcare Assistant

Are you passionate about supporting older people and making a meaningful differe...

Location

Ireland , Cork

Salary:

Not provided

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

Experience in elderly care is desirable but not essential (training may be provided)
QQI Level 5 in Healthcare Support or equivalent is an advantage
A caring, patient and respectful approach to supporting older people
Ability to work flexible shifts including days, nights, and weekends
Strong commitment to resident safety, dignity and wellbeing
Applicants must have legal entitlement to work in Ireland

Job Responsibility

Deliver person-centred care to residents with dignity and respect
Support residents with activities of daily living where required
Encourage independence and social engagement
Maintain a clean, safe and comfortable living environment
Build positive relationships with residents, families, and colleagues
Follow all health, safety and safeguarding procedures
Assist with compliance processes, inspections, and quality standards
Lead Healthcare Assistants will also assist in guiding care teams, supporting best practice, and helping maintain high standards of care delivery

What we offer

Flexible working hours to support work–life balance
Local employment opportunities within the Douglas, Cork area
Competitive rates of pay in line with experience and role
Supportive team environment with ongoing training and development
Employee wellbeing initiatives
Uniform provided
Free on-site parking
Meals provided while on duty

New

Bakery Team Member

Join us to "Change Hospitality For Good". Here at the Cornish Bakery, we want to...

Location

United Kingdom , Falmouth

Salary:

8.05 - 12.80 GBP / Hour

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

Eligible to live and work in the UK

Job Responsibility

Make the World’s Best Coffee
Deliver Outstanding Customer Service
Prepare Award Winning Food
Maintain High standards within the Bakery
Be part of a Team who strive to Aim Higher at all times

What we offer

50% discount on food and drink
Pasty Perks – bespoke reward system offering discounts and savings on favourite brands
Financial well-being benefit through Stream – save directly from wages into a high interest savings account or access wages before pay-day
Employer funded health and wellbeing services with access to a 24/7 GP line, Employee Assistance Program and discounted gym memberships
Paid birthday day off
Member of the shareholder fund (service dependent)
Team social events with in-bakery incentives
Up to 28 days of holiday (including bank holidays), pro rata if necessary

New

Housekeeping Assistant

In Glasgow's prestigious West End, Kelvinside Manor provides luxurious accommoda...

Location

United Kingdom , Glasgow

Salary:

12.27 GBP / Hour

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

Experience from a housekeeping or domestic cleaning role
Basic understanding of infection control, COSHH, and compliance standards
Ability to follow instructions and cleaning schedules
Ability to report issues
Ability to work well with others in a professional and courteous manner
Pride in your work, attention to detail, time management, and respectful communication
Ability to work well as part of a team or on your own
Demonstrating a kind and caring nature to all within the care home
Satisfactory references
Disclosure Scotland Scheme Membership (PVG)

Job Responsibility

Maintaining the highest levels of cleanliness in public areas and bedrooms within the home
Responsible for the wash, dry, iron and put away of laundry
Ensuring that our residents' care home facilities, public areas and rooms are maintained to the highest cleaning standards
Replenish and maintain supplies in both resident rooms and common areas
Communicate effectively with residents and colleagues to address needs and concerns

What we offer

Competitive benefits
Overtime rates
Flexible working hours considered

Parttime

Inpatient Coding Auditors

Clarus RCM

Location:
Philippines , Pasig, Manila

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
December 07, 2025

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Inpatient Coding Auditors

Inpatient DRG Nursing Auditor

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Inpatient Coding Auditors

Clarus RCM

Location:Philippines , Pasig, Manila

Category:IT - Administration

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:December 07, 2025

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Inpatient Coding Auditors

Inpatient DRG Nursing Auditor

Senior Clinical Coding Auditor & Trainer

Inpatient/DRG Validation Coding Auditor

DRG Validation Coding Auditor

Medical Director of Revenue Integrity

Healthcare Assistant & Lead Healthcare Assistant

Bakery Team Member

Housekeeping Assistant

Location:
Philippines , Pasig, Manila

Category:
IT - Administration

Contract Type:
Not provided

Job Posted:
December 07, 2025