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Senior Quality Assurance Manager

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Pasig, National Capital Region, Philippines beBeeMedicalCodingQA Full time ₱60,000 - ₱120,000
Job Description

As a seasoned Medical Coding QA Supervisor, you will be responsible for leading our quality assurance team in Same Day Surgery (SDS) and Observation coding. Your expertise will ensure compliance with regulations and organizational standards, driving continuous improvement in coding accuracy and productivity.

The ideal candidate will have advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems, with a strong focus on SDS procedures. They will oversee daily operations, conduct internal audits, monitor performance, and provide actionable feedback to improve team effectiveness.

This role requires exceptional analytical and problem-solving skills, excellent communication and leadership abilities, as well as strong attention to detail and commitment to accuracy and compliance.

Key Responsibilities:

  • Supervise daily operations of the coding QA team, specifically SDS & Observation audits.
  • Conduct internal audits to evaluate accuracy, consistency, and regulatory compliance in SDS coding, when needed.
  • Monitor coding performance and quality metrics; provide actionable feedback to improve team effectiveness.
  • Develop, implement, and maintain coding QA policies and procedures in collaboration with leadership.
  • Collaborate with coding education staff to identify training needs and deliver targeted education based on audit findings.
  • Act as a subject matter expert for SDS & Observation coding questions and escalated cases.
  • Ensure coding practices align with federal guidelines, payer-specific policies, and organizational goals.
  • Provide detailed reporting and analysis of audit results to leadership, identifying trends and risks.
  • Maintain up-to-date knowledge of coding standards, CMS regulations, payer guidelines, and industry best practices.
  • Participate in hiring, onboarding, and mentoring QA.
  • Support coding projects, system upgrades, and other initiatives as assigned.
Required Skills and Qualifications

Education & Certification:

  • Associate or bachelor's degree in health information management, Health Sciences, or related field preferred.
  • Active certification: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent required.
  • CPMA certification is preferred but not required.

Experience:

  • Minimum 5 years of medical coding experience, with at least 2 years specializing in Same Day Surgery (SDS) & Observation.
  • Minimum 2 years of supervisory or lead experience in a QA or auditing role.
  • Strong experience with CMS, NCCI edits, and payer-specific coding guidelines.
  • IVR experience is preferred but not required.
  • In-depth knowledge of ICD-10-CM, CPT, and HCPCS Level II coding systems.
  • Proficient with EHR and coding software (e.g., EPIC, 3M, Optum).
  • Exceptional analytical and problem-solving skills.
  • Excellent communication and leadership abilities.
  • Strong attention to detail and commitment to accuracy and compliance.
  • Ability to work independently and as part of a team in a fast-paced environment.
Benefits

This role offers opportunities for professional growth and development, with a dynamic and supportive team environment.

Others

We are committed to providing a safe and inclusive workplace, and we welcome applications from diverse candidates.