Certified Professional Coder at Genfinity Philippines, Inc.

Mandaluyong, Metro Manila, Philippines -

Full Time

Start Date

Immediate

Expiry Date

15 Jan, 26

Salary

0.0

Posted On

17 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Coding, CPT Coding, ICD-10 Coding, HCPCS Coding, Level of Service Auditing, Medical Documentation Analysis, Workers’ Compensation, Fee Schedule Application, Analytical Skills, Communication Skills, Problem-Solving Skills, Regulatory Compliance, Confidentiality, Collaboration, Training, Customer Service

Industry

Outsourcing and Offshoring Consulting

Description

Job Summary A Certified Professional Coder (CPC) will focus on conducting Level of Service audits, ensuring accurate coding of medical procedures and diagnoses, and maintaining compliance with federal, state, and payer-specific regulations. The ideal candidate will have a strong background in Workers’ Compensation, fee schedule application, and medical documentation analysis. Primary Duties & Responsibilities Perform Level of Service audits on medical bills to validate coding accuracy and appropriateness. Review and interpret complex medical documentation including office visits, consultations, surgeries, and hospital services. Apply CPT, ICD-10, and HCPCS coding standards to ensure proper billing and reimbursement. Ensure compliance with state-specific fee schedules, Workers’ Compensation regulations, and payer guidelines. Identify and resolve discrepancies in coding and documentation. Respond to provider appeals and inquiries with clear, regulation-based explanations. Collaborate with internal teams including customer service, billing, and compliance to resolve coding issues. Maintain up-to-date knowledge of coding guidelines, regulatory changes, and industry best practices. Protect the confidentiality of patient and provider information. Participate in ongoing training and maintain active CPC certification and required CEUs. Qualifications Experience with multi-state jurisdictional regulations. Understanding of Usual & Customary, PPO discounts, and non-fee schedule claims. Minimum 2 years of experience in medical coding, preferably in Workers’ Compensation or medical bill review. Background in hospital billing guidelines for inpatient and outpatient services. Prior experience in level of service auditing or clinical documentation improvement (CDI). CPC (Certified Professional Coder) certification required; CCS or CPC-A considered with relevant experience. Strong knowledge of CPT, ICD-10, HCPCS, and medical terminology. Familiarity with CompIQ Solutions or similar bill review platforms preferred. Excellent analytical, communication, and problem-solving skills.Ability to work independently and manage multiple priorities in a fast-paced environment. ------------- All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, or any other characteristic protected by law. Genfinity as an Equal Opportunity Employer, believes in each person’s potential, and we’ll help you achieve yours. All information will be kept confidential according to EEO guidelines. Privacy Notice & Consent We value your privacy. By submitting your information through this form, you are applying for a position at Genfinity Philippines, Inc. and voluntarily providing personal information, including your name, contact details, and resume. This information will be collected and processed solely for recruitment purposes, including evaluating your qualifications, assessing your skills, verifying your background, and contacting you about your application. Your personal data will be processed in accordance with the Data Privacy Act of 2012. You have the right to access, correct, or withdraw your data at any time. For more information, please refer to our Privacy Policy or contact our Data Protection Team at dpo@genfinity.net . By submitting this form, I acknowledge that I have read and understood the above Privacy Notice and hereby give my free, informed, and voluntary consent to the collection and processing of my personal information by Genfinity Philippines, Inc. for recruitment purposes.

Responsibilities

The Certified Professional Coder will conduct Level of Service audits and ensure accurate coding of medical procedures and diagnoses. They will also maintain compliance with various regulations and collaborate with internal teams to resolve coding issues.