Clinical Quality Assurance Specialist

5 hours ago

Metro Manila Philippines R1 RCM Full time

Clinical Quality Assurance Specialist R1 RCM National Capital Region, Philippines As a Multi‑Specialty Quality Reviewer, you will be responsible for conducting internal quality reviews across different medical coding specialties to assess coder performance and coding accuracy. This role focuses on identifying areas for improvement, enhancing coding efficiency, and providing educational opportunities to ensure that coding practices meet industry standards and compliance requirements. You will also assist in educating coders, resolving coding issues, and leading improvement initiatives. Additionally, you are expected to stay up to date with official coding guidelines and payer policies. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast‑growing team offers opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Qualifications At least 5 years of total work experience in medical coding for inpatient settings with exposure to multiple specialties. Currently holds and maintains at least one role‑related certification (RHIA, RHIT, CCS, CIC for inpatient roles). At least 5 years of total work experience in medical coding for outpatient facility settings with exposure to multiple specialties (coding or auditing for Same Day Surgery, Observation, ED). Preferred specialties: Ancillary, Clinic, Emergency, and Evaluation and Management. Currently holds and maintains at least one role‑related certification (CPC, COC, CCS, CCS‑P for outpatient roles, CPMA for auditing role). Benefits Medical Plan (HMO) from Day 1 of employment with free dependents. All Mandatory Statutory Benefits. Company Information Seniority level: Associate Employment type: Full‑time Job function: Quality Assurance, Health Care Provider, and Customer Service Industries: Medical Practices, Hospitals and Health Care, and Health and Human Services Equal Employment Opportunity Statement The company’s employment practices are not based on any protected characteristic. The company is committed to a workplace free from harassment based on any of the foregoing protected categories. #J-18808-Ljbffr

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