Vee Healthtek’s Assessment Partner
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Location / Work Arrangement / Schedule
Location: Ortigas, Pasig City
Employment Type: Full-time
Your Impact
As a Pre-Visit Risk Adjustment Auditor, you will strengthen the quality and defensibility of prospective reviews before the patient visit. Your audits help ensure HCC risk adjustment opportunities are accurate, clinically supported, compliant, and useful to providers.
This work sits at the intersection of clinical reasoning, documentation integrity, and U.S. healthcare operations. You will validate chronic condition opportunities, identify quality trends, and translate clinical findings into concise pre-visit insights that support better documentation and more consistent review outcomes.
What You’ll Do
Audit pre-visit and prospective reviews completed by CRS and HCC coders for accuracy, completeness, and clinical support.
Validate recapture conditions, reassessment conditions, missed opportunities, and suspected conditions using clinical indicators.
Review medical records, including prior-year HCCs, diagnoses, problem lists, encounter notes, labs, imaging, medications, and treatment plans.
Ensure audit decisions align with CMS HCC risk adjustment guidelines, client documentation standards, and recognized validation concepts such as MEAT/TAMPER.
Identify audit variances, quality trends, and improvement opportunities at the individual reviewer or coder level.
Provide clear, educational audit feedback that helps reviewers and coders improve accuracy and consistency.
Support audit defensibility and help reduce retrospective audit findings through clinically sound documentation review.
Identify clinically supportable undocumented chronic conditions and recommend appropriate provider query opportunities for prospective capture.
Translate clinical findings into concise, provider-friendly pre-visit insights and recommendations.
Other duties as assigned.
What You’ll Bring
Registered Nurse (RN), Philippines license required.
Bachelor of Science in Nursing (BSN) required.
US RN license, active or inactive, preferred but not mandatory.
AAPC certification, CPC or CRC, or AHIMA certification, CCS or CCS-P
Experience
1 to 2+ years of total clinical experience as an RN.
2 to 3+ years of experience in pre-visit/prospective reviews and/or regular HCC review and auditing.
Strong clinical exposure to chronic and complex conditions.
Skills
Strong clinical judgment and analytical skills with a good understanding of HCC risk adjustment and audit concepts.
Excellent attention to detail and consistency.
Ability to distinguish supported versus unsupported diagnoses.
Clear written communication for audit feedback and documentation.
Compliance-focused mindset with strong quality orientation.
Comfortable working in a global delivery model supporting U.S. healthcare systems.
Strong knowledge of Excel and data management.
What You Can Expect
You can expect clinically meaningful audit work with clear quality standards and direct connection to U.S. healthcare documentation integrity. The role gives you practical ownership of review accuracy, provider-ready insights, and continuous improvement in a growing risk adjustment function.
Benefits
HMO Coverage: Day-one HMO coverage with a Php 200,000 maximum benefit limit, plus 1 dependent for individual contributors or up to 2 dependents for managers and above.
13th Month Pay: Employees who work at least one month in the calendar year are eligible for 13th Month Pay, released on or before December 24 and computed according to Labor Code and DOLE guidelines.
Service Incentive Leave: 20 leave credits per year, prorated in the first year based on hire date.
Unused Leave Credit Monetization: Unused leave credits may be monetized at year-end, up to 5 days for individual contributors or up to 10 days for managers and above.
Night Differential: 10% night differential for eligible work hours.
Working Hours: 8 working hours per day, excluding a 1-hour lunch break.
Annual Performance Appraisal: Eligibility is based on individual and company performance.
Other Leaves: Includes applicable statutory leaves such as Magna Carta, Solo Parent, VAWC, Maternity, Paternity, and other legally mandated leaves.
About Us
Vee Healthtek is a technology-led revenue cycle partner for U.S. health systems and physician groups. We treat revenue cycle as a structural determinant of growth and resilience, not an administrative process. Our modular capabilities span every stage of the revenue cycle, enabling both targeted interventions and full-cycle transformation. By combining engineered workflows, practitioner insight, and a global delivery architecture, we turn revenue friction into flow - from access to A/R - and shift it from a cost center to a revenue performance system.
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