Quality Auditor, Medical Coding

apartmentGratitude Inc placeManila scheduleFull-time calendar_month 

Quality Auditor, Medical Coding

Job Responsibilities
Perform daily coding audits based on assigned audit sample coverage
Maintain at least 95% quality accuracy while collaborating effectively with team members and leaders
Ensure compliance with the company’s Coding Compliance Policy for both internal and external (client) audits
Identify coder performance gaps and recommend improvements to enhance overall coding quality
Utilize and demonstrate working knowledge of the EPIC system
Educational Requirements
Must hold certification from AHIMA or AAPC
Registered Nurse (RN) is preferred but not required
At minimum, candidates must be college graduates
Experience Requirements
At least 4 years of medical coding experience

Prior BPO experience in medical coding is required

Strong working knowledge of: Emergency Department (ED) and Observation coding

General surgical and bedside procedures

Injection & Infusion (I&I) coding, including: IV push

Chemotherapy
Non-chemotherapy infusion

Hydration

Proficiency in: Use of modifiers

Surgical supply charges

Resolving NCCI edits

Experience validating Revenue Codes: 0760 – Treatment/Observation Room

0762 – Observation Room

0761 and 0769 – Specific treatment rooms (as applicable)

Familiarity with: Carve-out procedure times

HCPCS codes (e.g., G0378, G0379)

Medical necessity requirements

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