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Job Specifications
Department: Healthcare Support
Employment type: Full-time
Work setup: On-site at a Get2Work hub (Manila, Cebu or Yerevan)
Experience level: Mid to senior
Employer: Get2Work (we are your employer of record)
Job Summary: ICD-10 and CPT coding under privilege and audit.
Key Responsibilities:
- Assign ICD-10 and CPT codes under privilege and audit
- Query providers on unclear documentation
- Keep coding accuracy above target
- Support compliance reviews
Working with AI: Healthcare back office runs on AI for coding suggestions, claim scrubbing and denial prediction. You supervise the models and own compliance.
- Use AI assisted coding and claim scrubbing to speed accurate submissions, then confirm against the chart
- Use denial prediction to prioritize the accounts most likely to pay
- Keep every AI assisted step inside HIPAA and audit rules
Competencies:
- Precision with clinical and claims data
- Strict adherence to HIPAA and privacy
- Persistence on denials and follow-up
- Empathy with patients and providers
- Comfort with audit and compliance
Skills:
- Knowledge of US healthcare revenue cycle
- Familiarity with payer portals and clearinghouses
- Understanding of medical terminology
- Careful, documented work
Tools you will use: Encoders (3M, Optum) and the client EHR
Education: Bachelor degree in a related field. Certifications relevant to the role are a plus.
Work Experience: Four to six years in the function, with ownership of outcomes.
Key Performance Indicators:
- Clean claim rate and denial rate
- Days in AR
- Coding and documentation accuracy
- Turnaround time on eligibility and authorizations