Job title: Quality Auditor - Coding

Work set up: Onsite Opportunity – MCK Taguig, Cyber Sigma Building

Work schedule: Day 9 am to 6 pm (Manila time)

Salary: 60K Max basic (not more than 30% hike)

HC:2

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ROLE SUMMARY

Auditor will be responsible for

examining and verifying the charts by having the coders reach the accuracy of 95% and above thereby

ensuring compliance with regulations and standards through education & continuous improvement.

RESPONSIBILITIES

• Handle the day-to-day audits of the coding based on audit sample coverage

•Ensure 95% quality on production and maintain good collaboration with team members & leaders

•Adherence to the company's Coding Compliance policy/plan on internal and external

audits(clients)

• To improve the coder's performance, identify issues and recommending areas needed for

improvement to enhance the quality

• Having EPIC software knowledge would be an added advantage

JOB DESCRIPTION

ED Charge audit QA:

• Strong knowledge on the ED procedures, CMS guidelines, E/M level assignment (99281-99285) and I&I

coding (IV push, chemo, and non-chemo infusion & hydration)

•Possess good knowledge in modifiers, surgical & medication supply charges in Rev codes 260, 450, 456,

459.

• Must know to validate the calculate ED timeline

OBS Charge audit QA:

•Strong knowledge on the ED, Observation, general surgical procedures, bedside procedures, and I&I

coding (IV push, chemo, and non-chemo infusion & hydration)

• Possess good knowledge in modifiers, surgical supply charges and resolving NCCI edits

• Should know to work with validating Revenue codes 760 (Treatment/Observation Room), 0762

(Observation Room), and sometimes 0761 and 0769 for specific treatment rooms.

• Familiar with carve out procedure time, usage of HCPCS codes (G0378, G0379) and medical necessity

SDS Charge audit QA

• Strong knowledge on surgical procedures (CPT 1-6 series) especially on the implants (cardiac,

musculoskeletal, obstetric, neuro, hearing), Endoscopies and L& D (Vaginal delivery, C-section)

• Familiar with charge audit process pertinent to Revenue codes for implants, surgical supplies (HCPCS

codes), medication and recovery room charges (Revenue code 710)

• Strong knowledge needed in I&I (IV push, infusion, hydration), modifiers and resolving NCCI edits

• Good domain on Cath lab procedures

• Possess good knowledge in Reporting of Extended Recovery and Bedded Outpatient Services such as s

blood transfusion, lumbar puncture, Incision & Drainage, injectable drug administration

Qualifications :

•Must have experience in Surgery, observation, and ED Facility specialty (Injection and infusion)

•Exposure in CPT codes (1 to 6 series Codes)

•Certification is mandatory

•5+ years’ experience in Coding

•1+ years as Quality or Good knowledge in Quality