Senior Medical Coder Outpatient ProFee Coding, HealthCare

The Finance Operations organization works with every part of Amazon to deliver world-class operations accounting and operational excellence with the highest standards of controllership and efficiency. We design operate and continuously improve the core systems and processes that accurately and timely pay suppliers invoice customers and report financial results that enable the business to scale with confidence.

Amazon Health Services (AHS) continues to rapidly expand its Healthcare FinOps capabilities to support the growth of its One Medical Commercial Health services. As part of the global Healthcare Finance Operations team you will work alongside highly driven talented professionals who are deeply committed to financial integrity scalability and process excellence. Success in this role requires a strong sense of ownership a passion for raising the bar and the ability to drive measurable results through continuous improvement of current- and future-state operations systems and workflows in close partnership with management and clinical stakeholders.

Amazon Healthcare Finance Operations is seeking experienced Medical Coders to support the Revenue Cycle Management for Commercial Health this role the Medical Coder will work closely with Clinical and Revenue Cycle partners to review validate and ensure the accuracy of professional fee coding in a commercial payer environment directly contributing to clean claim submission optimized reimbursement and overall revenue integrity.

This position is office-based in Pasay City.

Key job responsibilities
Partner with cross-functional Revenue Cycle Management (RCM) teams to support clean claim submission and optimal reimbursement across commercial and Medicare-related services including Evaluation & Management (E&M) services and Annual Wellness Visits (AWVs).
Manage multiple coding initiatives and daily production work to ensure accuracy quality and turnaround-time standards are consistently met.
Maintain current knowledge of CPT ICD-10-CM E&M guidelines modifier usage commercial payer policies and Medicare preventive service requirements.
Assign accurate diagnosis procedure E&M levels preventive service codes and applicable modifiers for professional fee encounters.
Review and resolve coding inquiries edits and payer responses within defined service-level expectations.
Work closely with Revenue Cycle functional teams to identify root causes of errors implement corrective actions and improve first-pass payment outcomes.
Analyze coding E&M leveling preventive service and denial trends and communicate actionable insights to leadership and clinical partners.
Support audits provider education and continuous improvement efforts focused on documentation quality and revenue integrity.

- CPC certification through AAPC and/or CCS certification through AHIMA is required
- 1 year as an outpatient and/or risk adjustment coder
- Demonstrates knowledge of health systems operations including an understanding of reimbursement methodologies and coding conventions
- Demonstrates the ability to perform accurate and complete chart reviews for HCC risk Adjustment
- Possess advanced knowledge and understanding of HCC risk adjustment coding and documentation requirements.
- Previous experience in a coding production environment.

- 1 years as an outpatient and/or risk adjustment auditor
- 1 years experience in Medicare/Medicare Advantage
- A CRC license must be obtained within one year of hire (to be sponsored)
- Must have strong experience in Microsoft or Google Suite in spreadsheets and PowerPoint
- Works effectively and efficiently within a team environment.
- Adaptable to shifting priorities and demonstrates willingness to do what it takes to meet client and team needs.
- Complies with policies and procedures for the confidentiality of all patient records and the security of systems.
- Ability to work independently and meet quality of work and workload expectations
- Ability to manage multiple projects
- Strong written verbal communication and attention to detail skills.
- Strong organizational analytical problem-solving and time management skills Our inclusive culture empowers Amazonians to deliver the best results for our customers.

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