Inpatient Coding Quality Reviewer

1 week ago


Manila, National Capital Region, Philippines R1 RCM Full time

As an Inpatient Coding Quality Reviewer, you will be responsible for conducting internal quality audits focused on inpatient medical coding to ensure accuracy, compliance, and adherence to official coding guidelines. This role emphasizes identifying coding errors, improving coding efficiency, and providing educational feedback to coders. You will collaborate with operations and training teams to maintain high standards of coding quality and compliance with payer policies and regulatory requirements.

Qualifications:

  • Minimum 5 years of inpatient medical coding experience, including exposure to multiple specialties
  • At least 2 years in a medical coding or billing review role
  • Holds at least one relevant certification: CCS, CIC, RHIA, RHIT
  • Strong knowledge of CMS guidelines, MS-DRG/APR-DRG and Inpatient Prospective Payment System (IPPS).
  • Proficiency with coding software such as Epic, Cerner, Meditech, and 3M 360
  • Additional specialty certifications (e.g., CPC, COC, CCS-P, CPMA) are a plus.
  • Experience in outpatient coding and auditing preferred.


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