Clinical Documentation Improvement (CDI) – USRN Medical Coder

Position Type: Mid, Individual Contributor

Employment Type: Full-Time

Work Setup: On-site, Night shift

Location: Pasig City

Industry: BPO

Base Salary: PHP 75,000 - 90,000

About the Job:

Join our client team as a Clinical Documentation Improvement Specialist, where you will apply your expertise in medical terminology and procedures to evaluate clinical documents, ensuring the accuracy and completeness of patient records. Collaborate closely with healthcare providers to educate them on documentation standards, thereby improving coding accuracy and revenue generation.

Company Profile:

Our client is a leading provider of professional services to the top healthcare organizations around the world.

Join our client team and unlock a range of enticing benefits, including:

• Competitive Base Salary
• Allowances
• HMO coverage from Day 1, plus one free dependent
• 20 Service Incentive Leaves
• Leave Conversion
• Night Differential
• Other Exciting Benefits

Required Qualifications:

• Must have an active PH or US RN license.
• Minimum of 2 years as an RN with concurrent inpatient CDI experience.
• CCDS or CDIP certification.
• Proficient in Microsoft Office.
• Must demonstrate effective verbal and written communication skills.

Scope & Responsibilities:

• Applying knowledge of medical terminology and procedures to evaluate clinical documents.
• Collecting medical information from healthcare providers and updating medical records.
• Verifying the accuracy of patient medical information and obtaining missing information.
• Facilitating and obtaining appropriate physician documentation for clinical conditions or procedures to support the severity of illness and expected risk of mortality.
• Interacting directly with physicians to clarify documentation and provide guidelines from ICD-9 and ICD-10 standards.
• Creating documentation education classes for general surgery residents to improve reporting levels and increase revenues.
• Clinically evaluating how the health record translates into coded data, including reviewing provider and other clinician documentation, lab results, diagnostic information, and treatment plans.
• Communicating with providers either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation, and clarifying information as necessary.
• Educating providers about identifying disease processes that reflect SOI, complexity, and acuity to ensure accurate code application.
• Communicating with healthcare team members to promote accurate and complete documentation of diagnoses and procedures that affect SOI in the health record.
• Demonstrating understanding of complications, comorbidities, SOI, ROM, case mix, and the impact of procedures on the billed record, and effectively imparting this knowledge to providers and other healthcare team members.
• Gathering and analyzing information relevant to documentation findings and outcomes and using it to develop action plans for process improvement.
• Perform other duties as assigned.

About Likha Careers:

Likha is a traditional Tagalog (Filipino) word that means ‘to create’ or creation. At its core, Likha Careers exists to help create a world where people of all walks of life have the opportunity to participate in a positive and rewarding career where happiness, pride, and financial security are achieved. We do this through thoughtful, people-centric career services.

Let’s create your career together!