Position: Medical Coder Location: Eastwood Libis Quezon City Work Set-up & Shift: Hybrid/Remote | Night Shift Our Client, CF Staffing Solutions is a leading Modern Business Process Outsourcing (BPO) company dedicated to helping you achieve unparalleled success. Our primary focus is to harness the power of outsourcing and drive your organization towards reaching its goals. We are seeking a detail-oriented and experienced Certified Medical Coder specializing in wound care billing to join our team. The ideal candidate will have a strong understanding of coding guidelines, medical terminology, and payer policies related to wound care services. The individual will be responsible for accurately assigning CPT, ICD-10-CM, and HCPCS codes, ensuring proper documentation, and optimizing reimbursement while maintaining compliance with federal and state regulations. Key Responsibilities: . Medical Coding & Billing: Assign accurate medical codes (CPT, ICD-10, HCPCS) for wound care services, including debridement, skin grafts, and negative pressure wound therapy (NPWT). . Compliance & Regulations: Ensure adherence to CMS, HIPAA, and payer-specific guidelines to prevent claim denials and audits. . Communication with Insurance Companies: IVR’s and claim status. . Claim Submission & Follow-Up: Prepare, submit, and monitor claims for wound care procedures, identifying and correcting coding errors to maximize reimbursement. . Revenue Cycle Support: Work with medical billers, insurance companies, and physicians to resolve claim denials, appeals, and payment discrepancies. . Documentation Review: Collaborate with healthcare providers to ensure complete and accurate documentation that supports medical necessity and coding compliance. . Insurance Verification: Assist in verifying insurance coverage, prior authorizations, and medical necessity for wound care treatments. . Education & Training: Provide guidance to physicians and clinical staff on proper coding practices and documentation improvement. Qualifications: . Certifications: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or equivalent. . Experience: Minimum 2 years of experience in Medical Billing and Coding , with a focus on wound care services preferred. . Knowledge: Strong understanding of Medicare, Medicaid, and commercial payer guidelines related to wound care. . Technical Skills: Proficiency in EHR/EMR systems, coding software (e.g., Encoder Pro, 3M), Microsoft Office, Netsuite, Smartsheet, and ZoHo. . Analytical & Communication Skills: Ability to analyze medical records, identify coding errors, and communicate effectively with providers and billing teams. Preferred Skills: . Experience with modifiers specific to wound care billing. . Familiarity with Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) for wound care. . Background in billing audits and appeals .
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