job description
Are you a licensed Professional Registered Nurse (PHRN) looking to advance your career in the healthcare technology sector? Optum is seeking a highly skilled Certified Medical Coder to join our dynamic team in Metro Manila. At Optum, we are dedicated to evolving health care, and your expertise in clinical documentation and accurate coding will play a pivotal role in ensuring we provide the highest quality of service to our patients worldwide.
In this role, you will be at the intersection of nursing and health informatics. You will interpret medical records, translate clinical services into standard codes, and contribute to the efficiency of global healthcare delivery. We provide a supportive environment, excellent work-life balance, and immediate benefits including Day 1 HMO coverage. Join us in our mission to help people live their healthiest lives.
Responsibility
- Accurately review and analyze clinical documentation and medical records for inpatient and outpatient services.
- Assign appropriate ICD-10-CM, CPT, and HCPCS codes to ensure accurate billing and compliance.
- Ensure that all coding activities adhere to established industry standards and regulatory requirements.
- Collaborate with healthcare providers to clarify documentation gaps and improve clinical accuracy.
- Participate in regular quality assurance audits to maintain high coding accuracy rates.
- Stay updated on changing healthcare laws, billing requirements, and coding guidelines.
- Maintain confidentiality and adhere to HIPAA and data privacy protocols at all times.
Qualifications
- Must be a licensed Professional Registered Nurse (PHRN).
- Must hold an active Certified Professional Coder (CPC-A) certification.
- Minimum of 1-2 years of experience in medical coding or clinical documentation improvement is preferred.
- In-depth knowledge of medical terminology, anatomy, and physiology.
- Strong analytical skills with an exceptional attention to detail.
- Ability to work in a fast-paced environment and meet strict productivity and quality targets.
- Excellent communication and interpersonal skills.
- Proficiency in electronic health record (EHR) systems and standard office software.