Save Job Back to Search Job Description Summary Similar JobsGain exposure to complex payer policies and Medicare guidelinesCollaborate cross-functionally with clinical and billing professionalsAbout Our ClientThe client is a globally leading healthcare firm based in the US with a shared service operation in the Philippines.Job DescriptionReview and validate diagnosis and medication coding for infusion services, especially under payer restrictionsEvaluate payer medical policies and CMS guidelines to assess medical necessity and coverage eligibilityEnsure alignment between clinical documentation and billing codes before services are renderedCoordinate and ensure proper completion of Advance Beneficiary Notices (ABNs), including correct modifier usageApply Medicare guidelines and FDA label coverage criteria in coding decisionsCollaborate cross-functionally with infusion intake, clinical, and billing teams to resolve discrepanciesIdentify and escalate complex reimbursement, compliance, or coding issuesMaintain detailed documentation to support audit readiness and complianceEnsure adherence to regulatory, payer, and internal billing policiesContribute to process improvements to enhance coding accuracy and reimbursement outcomesThe Successful ApplicantBachelor's degree in Health Information Management, Medical Coding, or a related fieldCertified Professional Coder (CPC) or equivalent certification from a recognised body1-3 years of experience in medical coding, billing, or revenue cycle operationsKnowledge of coding systems, payer rules, and healthcare workflowsFamiliarity with outpatient or ambulatory coding practicesUnderstanding of reimbursement guidelines and documentation standardsAbility to collaborate effectively with clinical and administrative stakeholdersExposure to government payer guidelines and compliance requirementsWhat's on OfferExposure to specialised coding practices and payer policy interpretationCollaborative and process-oriented team cultureCompetitive compensation aligned with industry standardsContactAnton TaboraQuote job refJN-062026-7039918Phone number+639176304327Job summaryFunctionExecutive SearchSub SectorHealthcare & Life SciencesWhat is your area of specialisation?Healthcare / PharmaceuticalLocationTaguigJob TypePermanentConsultant nameAnton TaboraConsultant contact+639176304327Job ReferenceJN-062026-7039918
