Medical Coder | BGC  

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 timelines.

• 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.

• At least 6 months of medical coding experience (e.g. Risk Adjustment, Inpatient/Outpatient, etc) is REQUIRED
• Active Medical Coding License (e.g. CPC - AAPC, CCS - AHIMA, etc.) is REQUIRED
• Candidate must possess at least a Bachelor's Degree, Professional License (Passed Board/Bar/Professional License Exam), Nursing or equivalent
• Proficient phone and computer skills, including MS Windows, MS Office, email and internet. Ability to learn additional applications as necessary
• Average English Communication skills, both oral and written
• Must be willing to work at Bonifacio Global City, Taguig