Clinical Quality Assurance Specialist
4 days ago
Overview Clinical Quality Assurance Specialist / Multi-Specialty Quality Reviewer role focused on conducting internal quality reviews across different medical coding specialties to assess coder performance and coding accuracy. Responsibilities Conduct internal quality reviews across different medical coding specialties to assess coder performance and coding accuracy. Identify areas for improvement, enhance coding efficiency, and provide educational opportunities to ensure coding practices meet industry standards and compliance requirements. Educate coders, resolve coding issues, and lead improvement initiatives. Stay up to date with official coding guidelines and payer policies. Work in an evolving healthcare setting, leveraging shared expertise to deliver innovative solutions. Contribute to a culture of collaboration and continuous learning to support patient care and service excellence. Qualifications IP QA: At least 5 years of total work experience in medical coding for inpatient settings with exposure to multiple specialties. Licensure/Certifications: Currently holds and maintains at least 1 role-related certification (RHIA, RHIT, CCS, CIC for inpatient roles). OP QA: 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). Other preferred specialties: Ancillary, Clinic, Emergency, and Evaluation and Management. Licensure/Certifications: Currently holds and maintains at least 1 role-related certification (CPC, COC, CCS, CCS-P for outpatient roles, CPMA for auditing role). What’s in it for you? Medical Plan (HMO) from Day 1 of employment with free dependents All Mandatory Statutory Benefits R1 RCM Inc. is an equal employment opportunity employer. Employment practices regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, or any other protected characteristic. The company is dedicated to a workplace free from harassment based on these categories. Visit us on Facebook: #R1Philippines #AllTogetherBetterinR1PH #J-18808-Ljbffr
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