Clinical Abstractors – Philippines

Responsibilities
REPORTING: Manager, Clinical Auditing Services - Philippines

POSITION SUMMARY

Clinical Abstractors are responsible for applying clinical and/or medical

coding knowledge in the review of evidentiary documentation in medical
records. This position requires the ability to perform accurate and complete
diagnostic coding, abstraction of pharmaceutical studies, HEDIS medical
records reviews, and other related duties in a high quality and production
environment.

SUMMARY OF RESPONSIBILITIES:

Clinical Abstraction assignments may include work from all lines of

Company’s business (e.g., diagnostic auditing, HEDIS reviews, drug
safety/efficacy studies). Each assignment will have specific requirements
and timelines.

Diagnostic Coding:
Clinical Abstractors review assigned medical records and apply appropriate
diagnostic codes and modifiers according to Generally Accepted Medical
Coding Guidelines, ICD-9 Guidelines and CMS Correct Coding Initiatives,
coding guidelines approved by CMS, and all rules, regulations and
guidelines promulgated by CMS and applicable to contractors and
subcontractors of CMS-approved sponsors (collectively the “Standards”),
all as reasonably interpreted by the Company.

HEDIS Reviews:
Clinical Abstractors review assigned medical records and document
measure specific clinical data according to NCQA technical specifications
for hybrid medical records reviews.
Health Outcomes Studies: Clinical Abstractors review assigned medical
records and document relevant clinical data according to stated study
objectives.
Health Outcomes Studies: Clinical Abstractors review assigned medical
records and document relevant clinical data according to stated study
objectives.

Requirements

• At least 3 years of professional nursing experience.

• Active RN license in good standing and certification from the United
States based National Council Licensure Examination (NCLEX-RN)
or National Philippines Nursing Accreditation equivalent
• Knowledge of ICD-9-CM diagnostic coding and inpatient and
outpatient coding guidelines, (experience with HEDIS and CMS HCC
Risk Adjustment coding and data validation is an advantage
• Two years experience with chart investigation, including medical
coding, HEDIS, QA, Disease Management, Utilization Review or
Case Management.
• Proven ability to perform in high production environment
• Must be willing to work on flexible schedule including night shift
• Must be willing to work in The Fort, Taguig

Job Package Details

This is the compensation package for this job opening:

Salary: Php 13000 to Php 15000 depending on your qualifications

HOW TO APPLY:
Please send your resume and cover letter to
join@microsourcing.com. Kindly write the position you're applying for
as the subject of your message.

For questions please call (02) 437-1000 and ask to be connected to

Manpower Acquisition Department
 Onsite Chart Acquisition Specialist

Responsibilities
Reporting: Scheduling Supervisor/Lead

Position Overview:

Outcomes Health assists health care providers in the review and/or

auditing of medical record data. The Onsite Acquisition Specialist
contacts medical facilities to request a medical record review via the
deployment of an onsite reviewer. This position operates within an
outbound call center environment and is driven by daily goals and project
deadlines.

The successful candidate will have experience in a fast paced, goal

oriented, outbound call center environment (customer service/sales).
Experience in dispatching personnel for various services is a plus but not a
requirement.

Hours and Work Schedule: 8 to 10 hour shifts ranging from a start time of
8:30AM to 11PM based on project needs.

Job Responsibilities:

• Contact by phone all assigned medical offices/facilities for the

following:

o Validation of demographic data for the medical provider’s location

o Confirmation of the presence of the requested chart(s)
o Scheduling of a field staff representative to go onsite for retrieval

• Managing the calendars of 7 to 12 field staff representatives,

ensuring that their work week is fully maximized based on their hourly
production rate/availability
• Research and resolve any scenario when a medical record is not
available or demographic data is not correct
• Document site interaction within our scheduling software
 • Compliance with all company policies and management instructions
• Participate in ongoing training
• Other responsibilities and duties as assigned

Requirements

• Ability to provide problem resolution and deal with irate customers

• Ability to multi-task
• Ability to clearly communicate both orally and written
• Ability to work under stress and adapt to change
• Must be flexible as daily duties can change during the duration of a
project
• Must be upbeat, self motivated, energetic and detail oriented with the
ability to schedule their assigned offices
• Must be computer literate with the ability to type a minimum of
30WPM

o Working knowledge of Microsoft Excel and word

o Ability to navigate via internet search engines (i.e. Google/Bing/Yahoo)

• Ability to respond to clients objections and effectively schedule the

receipt of medical records
• Ability to clearly explain the purpose of site reviews over the
telephone to provide offices
• Ability to balance productivity for required phone contacts and
complete required administrative work
• Ability to prioritize tasks based upon managements’ direction
• Must be willing to work on flexible schedule including night shift
• Must be willing to work in The Fort, Taguig
HOW TO APPLY:
Please send your resume and cover letter to
join@microsourcing.com. Kindly write the position you're applying for
as the subject of your message.

For questions please call (02) 437-1000 and ask to be connected to

Manpower Acquisition Department.
 Manager of Clinical Reading

Responsibilities
POSITION SUMMARY

The Manager of Clinical Reading will lead the development, coordination

and management of Auditing Division including Auditing, Production, Client
Relations, Quality Assurance, Training and Provider Education as required.
The incumbent will directly supervise and provide technical expertise to the
Clinical Reading Staff to assure target quality and production levels of
coded and abstracted clinical data within the Company databases. He/she
will work with senior management to improve work flow processes that will
facilitate coding/abstraction accuracy and data quality.

This position will direct and develop multi-level projects to improve and
support business goals and critical business strategies. This position will
report directly to the Vice President of Auditing Services based in the
Philippines.

SUMMARY OF RESPONSIBILITIES

Directs the coding/abstraction, production, and quality assurance, auditing

and training activities (as required) of the Auditing Division.
Develops detailed requirements and documents for all processes and
training within the Auditing Division.
Maintains oversight of certification requirements for the various disciplines
within the division’s departments and monitors professional information for
up-dates and changes in professional standards.
Develops and updates enterprise-wide reports.
Trouble shoots and collaborates with other managers to problem-solve and
advance the processes of the division and the Company as a whole.
Reports progress, obstacles, etc. to Vice President on a regular basis.
Interacts regularly with executive team and individual department heads
Requirements

REQUIRED EDUCATION & EXPERIENCE

• Certification as either a CCS, CCS-P, CPC, CPC-H or CRN-C

required;
• Certification from National Council Licensure Examination (NCLEX-
RN) or National Philippines Nursing Accreditation equivalent
• Additional certification as an RHIT or RHIA preferred;
• Active nursing license required (Registered Nurse or Licensed
Practical Nurse);
• 5 to 7 years in a combination of hospital/physician office coding and
supervisory work including ICD-9-CM diagnostic/procedure coding,
CPT, Evaluation and Management, DRG & APC systems, and
Medicare/Medicaid rules/regulations. Experience with HEDIS and
CMS HCC Risk Adjustment coding and data validation

REQUIRED KNOWLEDGE, SKILLS & ABILITIES

• Extensive knowledge of medical billing and payment methodologies,

including all coding guidelines for ICD-9, DRGs, APCs, emergency
department, and/or evaluation and management coding
(demonstrated understanding of CMS HCC Risk Adjustment coding
and data validation requirements preferred);
• Knowledge of multi-specialty physician practices and academic
settings (inpatient and outpatient)
• Proven medical background in anatomy, physiology, pathology,
medical terminology and pharmacology
• Ability to perform in a high production environment
• Ability to make administrative and procedural decisions and
judgments
• Ability to foster a cooperative work environment and build high
performing work teams
• Ability to plan, develop and coordinate multiple projects
• Skill in budget preparation and fiscal management, conflict resolution
and/or mediation skills
• Strong interpersonal and communication skills and the ability to work
effectively with a wide range of constituencies in a diverse community
• Must be willing to work on flexible schedule including night shift
• Must be willing to work in The Fort, Taguig

HOW TO APPLY:
Please send your resume and cover letter to
join@microsourcing.com. Kindly write the position you're applying for
as the subject of your message.

For questions please call (02) 437-1000 and ask to be connected to

Manpower Acquisition Department.
 Vice President of Clinical Reading

Responsibilities

POSITION SUMMARY

The VP of Clinical Reading will lead the development, coordination and

management of the Philippine based Clinical Reading Division including
Abstraction, Production and Client Relations as required. The incumbent
will directly supervise and provide technical and leadership expertise to
division staff to assure target quality and production levels of coded and
abstracted clinical data within the Company databases. He/she will work
with senior management to improve work flow processes that will facilitate
coding/abstraction accuracy and data quality.
This position will direct and develop multi-level projects to improve and
support business goals and critical business strategies. This position will
report directly to the Senior Vice President of Clinical Reading Services
based in the US.

REPORTING: Senior Vice President, Clinical Reading Services- (based in

USA)

SUMMARY OF RESPONSIBILITIES

• Directs the coding/abstraction, production and quality assurance

activities (as required) of the Clinical Reading Division.
• Responsible for performance management of teams and individuals
based on company standards for productivity and quality.
• Develops detailed requirements and documents for all processes
within the Division.
• Maintains oversight of certification requirements for the various
disciplines within the division’s departments and monitors
professional information for up-dates and changes in professional
standards.
• Develops and updates enterprise-wide reports.
 • Trouble shoots and collaborates with other managers to problem-
solve and advance the processes of the division and the Company as
a whole.
• Reports progress, obstacles, etc. to the Senior Vice President on a
regular basis.
• Interacts regularly with executive team and individual department
heads. This includes working directly with the broader US based
Operating and Clinical Reading Teams.

Requirements

REQUIRED EDUCATION & EXPERIENCE

• Certification as either a CCS, CCS-P, CPC, CPC-H or CRN-C

required;
• Certification from National Council Licensure Examination (NCLEX-
RN) or National Philippines Nursing Accreditation equivalent
• Additional certification as an RHIT or RHIA preferred;
• Active nursing license required (Registered Nurse or Licensed
Practical Nurse);
• 10 to 15 years in a combination of hospital/physician office coding
and supervisory work including ICD-9-CM diagnostic/procedure
coding, CPT, Evaluation and Management, DRG & APC systems,
and Medicare/Medicaid rules/regulations. Experience with HEDIS and
CMS HCC Risk Adjustment coding and data validation

REQUIRED KNOWLEDGE, SKILLS & ABILITIES

• Extensive knowledge of medical billing and payment methodologies,

including all coding guidelines for ICD-9, DRGs, APCs, emergency
department, and/or evaluation and management coding
(demonstrated understanding of CMS HCC Risk Adjustment coding
and data validation requirements preferred)
• Knowledge of multi-specialty physician practices and academic
settings (inpatient and outpatient)
• Proven medical background in anatomy, physiology, pathology,
medical terminology and pharmacology
• Ability to deliver in a high production environment
• Ability to make administrative and procedural decisions and
judgments
• Ability to foster a cooperative work environment
• Ability to plan, develop and coordinate multiple projects
• Skill in budget preparation and fiscal management, conflict resolution
and/or mediation skills;
• Strong interpersonal and communication skills and the ability to work
effectively with a wide range of constituencies in a diverse community
• Must be willing to work on flexible schedule including night shift
• Must be willing to work in The Fort, Taguig

HOW TO APPLY:
Please send your resume and cover letter to
join@microsourcing.com. Kindly write the position you're applying for
as the subject of your message.

For questions please call (02) 437-1000 and ask to be connected to

Manpower Acquisition Department.