Certified Medical Coder

The Medical Coder will be responsible for reviewing denied claims for coding and/or billing errors and determining appropriate action. The coder will be responsible for corrections to individual accounts which include CPT and/or ICD 10 correction, application of correct modifiers, etc. The Medical Coder is also responsible for ensuring that government, state, and local guidelines are followed. Payers include but are not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers

• Examining medical claims
• Verification of health insurance benefits
• Performing reviews of denied claims (coding and billing) to detect any coding errors and applying appropriate action. CPT, diagnosis, modifier updates.
• Ensure coding guidelines are followed (AMA, Medicare, Medicaid, and private payers).
• Review medical records to verify and substantiate diagnosis and procedures.
• Correcting and resubmitting claims
• Documenting actions taken
• Maintaining quality customer services
• Ensuring legal compliance

• 1-5 Years’ Experience in Revenue Cycle Management and Certification Billing/Coding.
• CPC or equivalent certification. (AAPC/AHIMA)(CPC-A accepted)
• Prior coding experience preferred
• Knowledge of Medicaid/Medicare guidelines preferred
• Working knowledge of managed care, commercial insurance, Medicare/Medicaid
• Understanding and adherence to HIPAA and PHI guidelines
• Comprehensive knowledge of insurance plans, member eligibility, and medical billing
• Understanding of CPT, ICD-10, UB, HCFA, and 837 terminologies
• Excellent interpersonal and customer service skills
• Detail oriented, strong problem solving, analyzing information and research skills
• Excellent math, verbal and communication skills
• Computer proficiency; experience with financial software,
• Documentation and data entry skills
• Ability to meet productivity goals based on portfolio
• Experience level will be confirmed at the time of hiring based upon factors set forth by the company
• Permanent day shift account but the training will be done in the graveyard shift
• Must be willing to work in the office located at Bonifacio Global City, Taguig City

We are HGS Offshore Staffing Solutions, a premier global partner in building offshore teams in the Philippines, with over 1,500 professionals across Metro Manila and Cebu.

Our goal is to ignite global potential by connecting exceptional talent with companies worldwide. We are committed to propelling your career forward by providing opportunities for growth, where your expertise can flourish in any field. Here, you'll have access to global industries, continuous training opportunities, and a culture where your voice always matters.

At HGS, we go beyond recruiting talented individuals, we cultivate a vibrant community. You'll be able to grow alongside your peers through professional development opportunities at your fingertips and connect with teammates during exciting company events. Our monthly huddles keep you connected with your team and colleagues. We also foster a dynamic community with our charity initiatives, reminding us that our careers can make a real difference. Whether you work remotely or side-by-side, you are always part of the team at HGS.