Description / Requirements

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)

Note : Former employees of AGS are not eligible for rehire, either through direct hiring or third-party vendors.

OUR COMPANY

AGS Health (AGS) is more than a revenue cycle management company – we’re a strategic partner for

growth. By blending technologies, services, and expert support, AGS partners with leading US health

systems, large physician practices and other RCM organizations to deliver tailored solutions that solve

the unique needs and challenges of the provider revenue cycle. AGS Health leverages the latest

advancements in automation, process excellence, security, and problem-solving via the use of

technology and analytics – all made possible with college-educated, trained RCM experts. AGS

employs more than 12,000 team members globally and partners with more than 150 clients across a

variety of care settings, specialties, and billing systems.

ROLE SUMMARY

Under the direction of the Medical Coding Vertical at AGS health, 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