Medical Coder - Revenue Integrity Audit
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At Clarus, we inspire you to explore your passions, nurture and cultivate your talent. We equip you to work with your clients and help them achieve outstanding results through superior quality of service. Innovate with Clarus, work on some of the most exciting projects in the industry and learn & grow with us.
If you are a certified medical coder, preferably with revenue integrity audit experience, please review the job description below and apply online:
Location: Pasig, Manila
Responsibilities
Performs Charge Reviews on the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPT coding, by reviewing the medical record, facility protocol, and other applicable documentation. The reviews may include the verification of billing data for accuracy and completeness, following regulatory requirements, to resolve edits or exceptions detected during system processing of the claim in the customer systems
Reviews that modifiers applied are appropriate based upon reviews, and/or makes necessary adjustments to patient account charges and/or balances
Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and standards
Evaluates if account combinations and account splits are appropriately applied
Aggregates charge capture issues, clinical documentation issues and revenue education opportunities to help clinicians understand their documentation responsibilities
Provides charge review results and presents findings to internal and client stakeholders
Coordinates charge reviews for retrospective or concurrent, and other billing reviews as identified
Reviews denial trends for documentation and missed charges/revenue opportunities and provides feedback on educational gaps
Desired Skills/Traits
Graduates in life sciences with 1 - 4 years of experience in Medical Coding
1-2 years audit experience
Prior clinical and/or coding background preferred
Experience in specialties such as Cardiology, Radiology, Pathology, Anesthesia, Emergency Room, Surgery, as well as in-patient settings
Sound understanding of coding/billing process and typical issues leading to denials and missed charges.
Exposure to CPT-4, ICD-9, ICD-10, and HCPCS coding
CCS/CPC/CPC-H/CIC/COC certification from AAPC /AHIMA would be a plus. Current Coding certification with valid proof of certifications would be needed
Good knowledge of medical coding and billing systems, regulatory requirements, auditing concepts, and principles
Benefits
Attractive Salary package
Saturday and Sunday Fixed Off
Other Benefits
Walk-in Venue:
Clarus RCM, 11th Floor, 22, Emerald Avenue ,
Ortigas Center, Pasig City PH- 1605
