Medical Coder (Registered Nurses)  

Medical Coders are responsible for applying clinical and/or medical coding knowledge in the review of evidentiary documentation in medical records. This position requires the ability to perform and complete diagnostic coding, abstraction of pharmaceutical studies, HEDIS medical records review and other related duties in a high quality and productive environment.

Responsibilities:

Clinical Abstraction assignments may include work from all lines of Company business (e.g., diagnostic auditing, HEDIS review, drug safety/efficacy studies). Each assignment will have specific requirements and time-lines.

• Diagnostic Coding: Clinical Readers review assigned medical records and apply appropriate diagnostic codes and modifiers according to Generally Accepted Medical Coding Guidelines, ICD-10-CM Guidelines and CMS Correct Coding Initiatives, coding guidelines approved by CMS, and all rules, regulations and guidelines promulgated by CMS and applicable to contractors and subcontractors of CMS-approved sponsors (collectively “Standards”), all as reasonably interpreted by the Company.
• HEDIS Reviews: Clinical Readers review assigned medical records and document measure specific clinical data according to NCQA technical specifications for hybrid medical records reviews.
• Health Outcomes Studies: Clinical Readers review assigned medical records and document relevant clinical data according to stated study objectives.
• Other specific details of the job will be made known to the employee by their immediate supervisor which may be in varying scope dependently on prevailing project undertakings.

• With at least 6 months of clinical / hospital experience
• Active Nursing License, REQUIRED
• Amenable to work in BGC, Taguig on a shifting schedule

-or-

• Active AAPC coding license, REQUIRED
• Amenable to work in BGC, Taguig on a shifting schedule