about OUR CLIENT: CHANGE HEALTHCARE
Change Healthcare is a healthcare technology company that offers software, analytics, network solutions, and technology-enabled services to help create a stronger, more collaborative healthcare system.
Change Healthcare Philippines is a captive center in the healthcare industry- they are a registered business entity here in the Philippines but their headquarters is in the US.
They are a global healthcare company operating in over 120 locations in the world, one of which is the Philippines and operates primarily in Picadilly Star in BGC, Taguig. They have various lines of businesses. The Philippine operations support their technology-enabled solutions such as software for medical imaging and major healthcare management processes such as financial management (medical claims), chart retrieval, clinical operations to name a few. "
POSITION SUMMARY
Medical Coder 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.
SUMMARY OF DUTIES & 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: Medical Coders 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 co
ntractors and subco
ntractors of CMS-approved spo
nsors (collectively “Standards”), all as reaso
nably interpreted by the Company.HEDIS Reviews: Medical Coders review assigned medical records and docu
ment measure specific clinical data according to NCQA technical specifications for hybrid medical records reviews.Health Outcomes Studies: Medical Coders review assigned medical records and docu
ment 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.
REQUIRED EDUCATION AND EXPERIENCE
Active AAPC/CPC license, requiredAt least 12 mo
nths clinical experience, requiredICD-9-CM/ICD-10-CM/HCPCS/PCS coding experience, preferred
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES
Exemplary attention to detail and completeness - must maintain a minimum QA score of 95% or higher across all projects.Excellent knowledge of medical records.Extensive knowledge of ICD-9-CM/ICD-10-CM outpatient diagnosis coding guidelines.Ability to code using an ICD-9-CM/ICD-10-CM code book (without using an encoder).Strong clinical skills related to chro
nic illness diagnosis, treatment and management.Ability to decipher difficult-to-read handwriting.Detail-oriented in all aspects of work.Excellent interpersonal, written and verbal communication skills.Strong organizatio
nal ability to manage projects with tight timelines.Ability to move from project to project with little to no additio
nal training (after initial orientation to project).Reliability and a commitment to meeting tight deadlinesProficient phone and computer skills, including MS Windows, MS Office, email and internet. Ability to learn additio
nal applications as necessary.Strong team player willing to take on additio
nal projects and duties as necessary.Demo
nstrates strong leadership skills.
PHYSICAL REQUIREMENTS & WORKING CONDITIONS
Will be primarily ba
sed out of the Change Healthcare’s Bo
nifacio Global City, Philippines office;May be assigned the 1st(day shift), 2nd (mid shift),or 3rd shift (graveyard shift)