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  • Philippines NCR, Metro Manila, Mandaluyong, Philippines
  • 3 Years
  • Full-time
  • Negotiable
  • Bachelor's / College Degree
  • 2 Vacancies
Closing Date: December 23, 2021
Salary Details


Job Address


Job Description

Skills and Requirements:

  • Should have active CPC License (active within 6 months). Okay even WITHOUT USRN/ PHRN license.
  • Should have atleast 1 year medical coding experience to be qualified for CL11. Okay with no work experience/1 year below/CL12 (willing to amend if any).
  • Ability to code using ICD-10 code book (without using an encoder).
  • Computer proficiency (including MS Windows, MS Office, and the internet)


  • Knowledge of HIPAA recognizing a commitment to privacy, security and confidentiality of all medical charts.
  • Strong clinical skills related to chronic illness diagnosis, treatment and management
  • Knowledge of HCC concepts and impact on Population Health Risk
  • Adjustment reimbursement initiatives.
  • 2 years claims operations and/or customer service (BPO or Non BPO, preferred BPO)



  • Abstracts, sequences and assigns diagnosis and procedure codes according to the Center for Medicare & Medicaid Services - Hierarchical Condition Categories (CMC - HCC), Department of Health and Human Services - Hierarchical Condition Categories (DHHS-HCC) and all CPT and ICD 9 & 10 guidelines.
  • Conducts thorough review of charts by assigning ICD codes, selecting the status and evidence for the Dx, and applying deletion reasons for Dx codes identified
  • Effectively uses computer assisted coding tools to review and interpret medical records and applies in-depth knowledge of coding principles to validate missing, incomplete or incorrect CPT and diagnosis codes
  • Demonstrates advanced knowledge of medical terminology, anatomy and physiology to identify all appropriate coding based on Centers for Medicare and Medicaid Services Hierarchical Condition Categories (CMS-HCC) and Department of Health and Human Services - Hierarchical Condition Categories (HHS-HCC) models.
  • Manages individual quality of work & productivity toward meeting or exceeding targets
  • Performs administrative tasks and work as directed by Team Lead/Operations Lead/Quality Lead. Consults clinician and Team Lead/Operations Manager timely and appropriately

Interested and Qualified candidates should forward their resume and cover letter to, using the job title as the mail subject.

Job Requirements

CPC License, HIPAA, ICD - 10, Claims Operations, Customer Service

Job Type

Customer Service/BPO

Working Hours

12:00 AM to 12:00 AM

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