Clinical Documentation Auditor

Company : Neolytix

Job Type : Full Time

Pasig City, Metro Manila

Number of Applicants

000+

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Job Description - Clinical Documentation Auditor

Job Description

Position Title: Clinical Documentation Auditor
Location: Metro Manila / Greater Manila Area, Philippines (hybrid)
Department: Documentation Audit & Compliance
Reports to: Coding Manager – PH Operations
Employment Type: Fulltime | Exempt

Role Summary

As part of Neolytix’s Documentation Audit Program, the Clinical Documentation Auditor reviews AI generated (NeoScribe™) and provider entered encounter notes to verify coding accuracy, clinical validity, and regulatory compliance. You will perform concurrent and retrospective audits, deliver actionable feedback to providers and coders, and safeguard clients against payer takebacks and OIG findings.

Key Responsibilities

Focus Area	Typical Tasks
Chart Auditing	• Apply ICD10CM, CPT®, HCPCS, and CMS E/M guidelines to 25–35 charts per shift. • Perform dual coding and resolve interrater discrepancies within 24 hours. • Conduct clinical validation to confirm medical necessity of all up coded services.
Compliance & Quality	• Maintain immutable audit logs in the compliance repository. • Flag potential upcoding/down coding, cloned notes, and diagnosis procedure mismatches. • Achieve ≥ 95 % interrater reliability and ≤ 3 % overall error rate.
Feedback & Coaching	• Create chart specific feedback and trend reports for providers and CDI coaches. • Participate in 15minute microlearning huddles; share specialty specific insights.
Data & Reporting	• Update audit dashboards (Power BI) with accuracy, denial, and turnaround metrics. • Support external payer audits by packaging requested documentation within SLA.
Process Improvement	• Recommend AI prompt or template refinements to reduce recurring documentation gaps. • Contribute to Lean/Six Sigma projects that improve throughput or reduce rework.

Required Qualifications

Education: Associate’s or Bachelor’s degree in Nursing, Health Information Management, or equivalent clinical discipline.

Certification (at least one active): CPC, CCS, COC, CIC, RHIA/RHIT, or CCDS.

Experience: 3 + years U.S. professional fee and/or facility coding, including at least 1 year in a formal audit or QA capacity.

Regulatory Knowledge: Deep familiarity with CMS E/M 2023+ guidelines, HCC risk adjustment, OIG CPG, HIPAA privacy & security.

Technical: Hands on with at least one major EHR (Epic, athenahealth, eClinicalWorks) and an encoder (3M, TruCode, Optum). Excel pivot tables; comfort navigating BI dashboards.

Language: Excellent written and spoken English (minimum CEFR C1).

Essential Skill Sets

Skill Category	Specific Competencies
Coding & Clinical Acumen	• Mastery of ICD10CM & CPT® conventions, modifiers, HCCs. • Ability to interpret clinical terminology across multiple specialties (e.g., ortho, GI, cardiology).
Analytical & Detail Orientation	• Detect subtle documentation gaps and pattern anomalies. • Root cause analysis of denial trends and coder variance.
Technology Proficiency	• Comfortable auditing AI generated notes and suggesting prompt tweaks. • Basic SQL or Power Query skills to slice audit datasets (nice to have).
Communication & Coaching	• Write concise, constructive feedback that providers will act on. • Confident presenting findings on video calls with U.S. clinicians.
Compliance Mindset	• Uphold separation of duties (no production based incentives). • Protect PHI and follow zero defect documentation standards.
Time & Self Management	• Meet 48hour audit turnaround and daily production targets. • Adapt to U.S. Central time overlap and rotating specialty queues.

Compensation & Benefits (guideline)

Base salary: ₱40 000 – ₱65 000 per month, adjusted for certification mix and inpatient specialty expertise.

Night differential: 10 % of base for shifts past 10 p.m.

Performance bonus up to 10 % tied to accuracy & TAT KPIs.

HMO for employee + 2 dependents on Day 1; annual certification renewal subsidy.

Application Instructions

Email your résumé, proof of active certification, and a one page summary of your most challenging audit case to [email protected] (cc [email protected]) with the subject line “Documentation Auditor – PH.”

Join Neolytix and help ensure that AI powered clinical documentation is accurate, compliant, and audit proof for providers across the United States.

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