C
Clarus RCM
Medical Coder - Revenue Integrity Audit
2 years ago
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Important information
Contract type:
Permanent
Location:
Pasig, Metro Manila, Philippines
Work mode:
Onsite
Published on:
8 September 2026
What they need
- Performs Charge Reviews on the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPT coding, by reviewing the medical record, facility protocol, and other applicable documentation. The reviews may include the verification of billing data for accuracy and completeness, following regulatory requirements, to resolve edits or exceptions detected during system processing of the claim in the customer systems
- Reviews that modifiers applied are appropriate based upon reviews, and/or makes necessary adjustments to patient account charges and/or balances
- Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and standards
- Evaluates if account combinations and account splits are appropriately applied
- Aggregates charge capture issues, clinical documentation issues and revenue education opportunities to help clinicians understand their documentation responsibilities
- Provides charge review results and presents findings to internal and client stakeholders
- Coordinates charge reviews for retrospective or concurrent, and other billing reviews as identified
- Reviews denial trends for documentation and missed charges/revenue opportunities and provides feedback on educational gaps
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