j1122-0516 - outpatient coding Auditor (rn, ccs/cpc/coc)CGI

The Outpatient Coding Auditor is a member of the CGI Healthcare Payment Integrity Team with responsibility for rendering appropriate, well-supported, and thoroughly-documented decisions which may result in the identification of improper payments on paid claims to various providers of clinical services, including outpatient hospital, ambulatory surgical centers, Home Health and DME providers.
Your future duties and responsibilities:
Reviews medical records to identify recovery opportunities on claims for Outpatient and Professional and Allied Services
Correctly interprets and utilize reference materials, including coding standards and guidelines, CPT Assistant, Coding Clinic for Outpatient and client payment polices.
Provides ongoing input to the Edit Development team on claims selection criteria and new recovery concepts.
Complies with department standards regarding productivity and audit quality and performs other duties as assigned.
Completes training and education on audit processes, industry changes and other topics as needed.
Required qualifications to be successful in this role:
Registered Nurse (active/unrestricted) current AHIMA or AAPC credentials (RHIT or RHIA and CCS-P, CPC, or CPC-H/COC).
Minimum 3-5 years outpatient coding experience.
Extensive knowledge of ICD 9/10 and CPT/HCPCS coding and APC reimbursement.
Understanding of Medicare/Medicaid and Commercial provider reimbursement methodologies.
Solid working knowledge of computer functions and applications such as Microsoft Office (Outlook, Word and Excel) and Windows operating systems.
The ability to write a well-reasoned review in a narrative style with correct spelling, grammar, punctuation and sentence structure is required for success in this position.
Amenable to work in mid and/or night schedule.
Amenable to work on a hybrid set-up (Office Location: Mckinley, Taguig)
Skills:
Communication (Oral/Written)
Multi-tasking
Analytical Thinking
Detail-oriented
Listening
What you can expect from us:
Insights you can act on
While technology is at the heart of our clients' digital transformation, we understand that people are at the heart of business success.
When you join CGI, you become a trusted advisor, collaborating with colleagues and clients to bring forward actionable insights that deliver meaningful and sustainable outcomes. We call our employees "members" because they are CGI shareholders and owners, and, as owners, we enjoy working and growing together to build a company we are proud of. This has been our Dream since 1976, and it has brought us to where we are today-one of the world's largest independent providers of IT and business consulting services.
At CGI, we recognize the richness that diversity brings. We strive to create a work culture where everyone belongs, and we collaborate with clients in building more inclusive communities. As an equal opportunity employer, we empower all our members to succeed and grow. If you require an accommodation at any point during the recruitment process, please let us know. We will be happy to assist.
Ready to become part of our success story? Join CGI-where your ideas and actions make a difference.
CGI

Manila City, Metro Manila Taguig City, Metro Manila
Permanent
Full-time