Certified Medical Coder (Remote) - Manila

Job Description

Expectation and Knowledge:

• Advanced knowledge of medical coding and billing systems, groupers, crosswalks, and classification systems including proficiency in regulatory requirements.
• Possess thorough knowledge of anatomical and medical terminology, demonstrating a natural curiosity and analytical mindset.
• Ability to create and maintain crosswalks matching up/ recommend the equivalent codes based on coding guidelines.
• Research and bring in international and regional medical coding schemas/ classifications, crosswalks, risk adjustment tools, reference lists/ value sets and drug/ medical device directories to the database, enhancing company's medical coding assets and highlighting the standards licensing requirements (wherever applied).
• Analyse and interpret claims line level descriptions, and other documentation, and convert them into codable format to the best of clinical and coding knowledge.
• Review and verify codes for diagnoses, procedures and treatment, and observations for coding inaccuracies and deficiencies as part of codes quality checks.
• Serve as resource and subject matter expert to other coding staff.

Qualifications, Certifications & Experience:

• Bachelor's degree (or equivalent) in Health Information Systems, Life Sciences, or a healthcare-related field is required. Candidates must be certified medical coders with credentials from AAPC or AHIMA, such as CPC, CRC, CCS, or CCS-P.
• A minimum of three years of experience as a certified medical coder is also necessary.
• Proficiency in major international coding standards, including ICD-9/10 PCS, ICHI, Current Procedural Terminology (CPT), ICD-10-CM, HCPCS, Anatomical Therapeutic Chemical (ATC) classification, RxNorm, and Global Medical Device Nomenclature (GMDN), is essential.
• Experience with SNOMED and LOINC is preferred.
• Familiarity with APAC regional coding schemas, such as the Malaysian Medical Association (MMA) system for Malaysia, Thai Medical Terminology (TMT) and Thai Medical Laboratory Terminology (TMLT) for Thailand, and the Table of Surgical Procedures (TOSP) for Singapore, is an advantage.
• Additionally, candidates should be skilled in using Risk Adjustment tools, including Hierarchical Condition Categories (HCC), diagnosis-related groupers, disease episode groupers, patient risk scores, and disease staging tools.
• Proficient in using Microsoft Office applications, including Excel, Word, PowerPoint, and Visio, with extensive knowledge of Anatomy and Physiology.
• Capable of working independently and collaboratively within a team environment, and comfortable delivering formal presentations to both large and small groups or individuals.

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