Save Job Back to Search Job Description Summary Similar JobsWork on complex infusion coding and reimbursement scenariosBuild expertise in Medicare guidelines in a specialised settingAbout Our ClientThe client is a globally leading healthcare firm based in the US with a shared service operation in the Philippines.Job DescriptionReview diagnosis and medication coding for infusion services, particularly in complex or restricted payer scenariosEvaluate payer medical policies and regulatory guidelines to determine coverage and medical necessityEnsure alignment between clinical documentation and billing codes prior to service deliveryCoordinate and validate completion of beneficiary notices and required modifiers within the systemApply advanced knowledge of Medicare guidelines and FDA label coverage to resolve coding exceptionsCollaborate with intake, billing, and clinical teams to address discrepancies and improve documentation practicesIdentify and resolve complex reimbursement and compliance issues, escalating where necessaryMaintain clear, audit-ready documentation to support coding decisions and post-payment reviewsSupport adherence to regulatory, payer, and organisational billing standardsParticipate in process improvement initiatives to enhance coding accuracy and reimbursement outcomesTrain and mentor junior team members on coding practices, systems, and workflowsThe Successful ApplicantBachelor's degree in Nursing, Health Information Management, Medical Coding, or a related fieldActive Certified Professional Coder (CPC) certification or equivalent; or active nursing licenceAt least 3 years of experience in medical coding, healthcare billing, or revenue cycle managementStrong understanding of coding systems, payer policies, and healthcare workflowsExperience interpreting Medicare guidelines and infusion-related coding practicesAbility to analyse complex coding scenarios and resolve reimbursement challenges independentlyStrong collaboration and communication skills for cross-functional engagementExperience in hospital outpatient or infusion coding environments is preferredAdditional certifications in outpatient or oncology coding are advantageousExposure to multilingual environments is a plusWhat's on OfferOpportunity to work on specialised and complex healthcare coding casesExposure to a structured, compliance-driven global organisationContinuous learning and professional development in advanced coding practicesCollaborative work environment with cross-functional team engagementContactAnton TaboraQuote job refJN-062026-7039916Phone number+639176304327Job summaryFunctionExecutive SearchSub SectorHealthcare & Life SciencesWhat is your area of specialisation?Healthcare / PharmaceuticalLocationTaguigJob TypePermanentConsultant nameAnton TaboraConsultant contact+639176304327Job ReferenceJN-062026-7039916
