Certified Medical Coder

JOB SUMMARY

The Medical Coder is responsible for reviewing and accurately coding medical records. This includes assigning appropriate ICD-10-CM, CPT, and HCPCS codes based on physician documentation to ensure accurate billing, reimbursement, and compliance with regulatory guidelines.

The role requires strong knowledge of surgical coding, observation services, evaluation and management (E/M) guidelines, and payer-specific requirements. The coder ensures coding accuracy, maintains productivity and quality standards, and adheres to compliance and confidentiality policies.

ROLES AND RESPONSIBILITIES

1. Review and analyze medical records for Outpatient cases.
2. Assign accurate ICD-10-CM, CPT, and HCPCS codes based on provider documentation.
3. Ensure compliance with official coding guidelines, payer policies, and regulatory requirements.
4. Apply correct Evaluation and Management (E/M) coding for observation services when applicable.
5. Validate medical necessity and ensure proper documentation supports coded services.
6. Identify and resolve coding discrepancies or documentation gaps through queries when needed.
7. Maintain established productivity and quality standards.
8. Stay updated with coding changes, industry regulations, and payer-specific guidelines.
9. Protect patient confidentiality in accordance with HIPAA and company policies.
10. Participate in audits, feedback sessions, and continuous process improvement initiatives.

JOB REQUIREMENTS

• Bachelor's degree in health information management or related Allied Health discipline. Nursing graduate is preferred.
• Certified Medical Coder (e.g., CPC, CCS, or equivalent certification).
• Minimum of 1–3 years of experience in OP medical coding.
• Strong knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines.
• Experience with Evaluation and Management (E/M) coding for observation services.
• Familiarity with payer-specific guidelines and reimbursement methodologies.
• Ability to review and interpret operative reports and clinical documentation accurately.
• High attention to detail with strong analytical and problem-solving skills.
• Ability to meet productivity and quality standards in a fast-paced environment.
• Proficient in using electronic medical records (EMR) and coding software.
• Good communication skills for provider queries and team collaboration.
• Understanding of HIPAA regulations and patient confidentiality standards.

Work arrangement: WORK ONSITE (ALABANG CITY)

Schedule: Morning shift

• Office location: Alabang Corporate Center