Senior Clinical Coder

Knowledge, and Expectations:

• Advanced knowledge of medical coding and billing systems, groupers, crosswalks, and classification systems including proficiency in regulatory requirements.
• Possess thorough knowledge of anatomical and medical terminology, demonstrating a natural curiosity and analytical mindset.
• Ability to create and maintain crosswalks matching up/ recommend the equivalent codes based on coding guidelines.
• Research and bring in international and regional medical coding schemas/ classifications, crosswalks, risk adjustment tools, reference lists/ value sets and drug/ medical device directories to the database, enhancing companys medical coding assets and highlighting the standards’ licensing requirements (wherever applied).
• Analyse and interpret claims line level descriptions, and other documentation, and convert them into codable format to the best of clinical and coding knowledge.
• Review and verify codes for diagnoses, procedures and treatment, and observations for coding inaccuracies and deficiencies as part of codes quality checks.
• Serve as resource and subject matter expert to other coding staff.

Technical, and Soft Skills:

• Meet and maintain established quality coding goals, ensuring accuracy and compliance with coding standards.
• Use independent judgment to handle confidential information appropriately, adhering to company requirements.
• Excellent organizational and time management abilities to handle multiple tasks and meet deadlines.
• Experience using Microsoft Office (Excel, Word, PowerPoint, Visio)
• Extensive knowledge of Anatomy and Physiology
• Demonstrated capacity to work independently as well as in a team environment.
• Comfortable presenting formal presentations to both large or small groups or individuals
• Strong communication skills, written and verbal.
• Strong team player and emotional intelligence.
• Ability to make decisions based on independent thinking and business objectives.

Qualifications, Certifications & Experience:

• Bachelor's degree (or equivalent) in health information systems, Life Sciences, or in a healthcare related field.
• Certified medical coder with Certification(s) from AAPC or AHIMA including but not limited to CPC, CRC, CCS, or CCS-P.

•       Required Work Experience:  At least 3 years’ experience as a certified medical coder.

• Must have experience in most of the international coding standards such as ICD9/10PCS, ICHI, Current Procedural Terminology (CPT), International Classification of Disease 10th Edition -Clinical Modification (ICD-10-CM), and Health Care Procedure Coding System (HCPCS), Anatomical Therapeutic Chemical (ATC), RxNorm, Global Medical Device Nomenclature (GMDN),
• Experience working with SNOMED & LOINC is preferred.
• Experience working with APAC regional schemas like Malaysian Medical Association (MMA) for Malaysia, Thai Medical Terminology (TMT) and Thai Medical Laboratory Terminology (TMLT) for Thailand, Table of Surgical Procedures (TOSP) for Singapore etc. is preferred.
• Well versed in Risk Adjustment tools like (HCC), diagnosis related groupers, disease episode groupers, patient risk scores, disease staging tools, etc.