Clinical Quality Assurance Specialist

5 hours ago

Manila, National Capital Region, Philippines R1 RCM Full time $40,000 - $80,000 per year

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 will focus 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 improvement initiatives.

Additionally, you are expected to be up to date with the 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 has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer competitive benefits.

Qualifications:

IP QA:

  • At least 5 years of total work experience in medical coding for inpatient settings with exposure to multiple specialties.
  • License/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.

  • License/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?


• Competitive Total Rewards Package


• Target variable incentives


• Medical Plan (HMO) from Day 1 of employment with free dependents


• Life insurance


• Paid Time-Off Benefits


• Sick Leave Conversion


• Night Differential offered


• Employee Referral Program


• All Mandatory Statutory Benefits

R1 RCM Inc. ("the Company") is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, or any other characteristic protected by local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

Visit us on Facebook:

R1Philippines #AllTogetherBetterinR1PH

  • Quality Assurance Specialist

    2 weeks ago

    Manila, National Capital Region, Philippines 3b536e3b-7daf-4a6b-815f-b9617e8b25d9 Full time ₱250,000 - ₱750,000 per year

    Company DescriptionSince 2019, AF Hospitality has been transforming Metro Manila's dining experiences with innovative concepts such as a mano, Ramen Ron, and Steak & Frice. Dedicated to creating unique culinary moments, our focus extends beyond great food to delivering exceptional service that makes every guest feel truly at home. As a growing community, we...

  • Experienced RN Quality Assurance Officer for Hospice

    5 hours ago

    Manila, National Capital Region, Philippines Hygieia Full time ₱800,000 - ₱1,200,000 per year

    Looking for Experienced RN Quality Assurance Officer for Hospice specifically with HospiceMD chartingAbout Us: Hygieia is a leading provider of compassionate hospice care dedicated to improving the quality of life for patients and their families. We are seeking a dedicated and experienced Hospice QA Specialist to join our dynamic team. If you are passionate...

  • Quality Assurance Specialist

    2 weeks ago

    Manila, National Capital Region, Philippines Salmon Group Ltd Full time ₱250,000 - ₱500,000 per year

    Salmon – Who We Are and What We DoSalmon is a fast-growing consumer fintech group, founded in July 2022 with the vision of creating the best credit-led neobank in Southeast Asia. We chose the Philippines to be our first market and are now a licensed consumer-lending group, working towards becoming a licensed bank (subject to BSP approval).Salmon was...

  • Experienced RN Quality Assurance Officer for Home Health

    6 hours ago

    Manila, National Capital Region, Philippines Hygieia Full time ₱900,000 - ₱1,200,000 per year

    Looking for Experienced RN Quality Assurance Officer for Home Health specifically with experience on EMR such as Notified/Perfect & Ultra/DSLAbout UsHygieia is a leading provider of compassionate home health care services, dedicated to enhancing the quality of life for patients and their families in their own homes. We are currently seeking an experienced...

  • Senior Quality Assurance Specialist

    5 hours ago

    Manila, National Capital Region, Philippines Firefly Electric & Lighting Corporation Full time ₱1,200,000 - ₱2,400,000 per year

    About the RoleLocation:Ermita, ManilaRole Type:Full-time, OnsiteDepartment:Corporate Planning, Assurance, and GovernanceReporting to:QMS ManagerWork Schedule:5-day work weekTheSenior Specialist for Quality Assuranceis in charge of guaranteeing the implementation of the Quality Management System (QMS) standards, including risk management, within the company....

  • Quality Assurance Specialist

    5 hours ago

    Manila, National Capital Region, Philippines Emapta Full time ₱450,000 - ₱900,000 per year

    Setting the Standard for Responsible Financial Solutions Our client, iCash, is a leading Canadian fintech company specializing in responsible short-term lending solutions. With a strong commitment to transparency, compliance, and customer respect, iCash leverages advanced technology to make borrowing simple, secure, and empowering. Join a team that values...

  • Quality Assurance

    6 hours ago

    Manila, National Capital Region, Philippines DELICE FOOD INC. Full time ₱400,000 - ₱600,000 per year

    QUALIFICATIONS:Bachelor's Degree: In Food Science, Food Technology, Microbiology, Chemistry, or a related field.Certification: In Food Safety, Quality Assurance, or HACCP (Hazard Analysis and Critical Control Points).At least 1-3 years in food manufacturing, bakery operations, or quality assurance roles.Familiarity with GMP (Good Manufacturing Practices),...

  • Quality Assurance

    4 hours ago

    Manila, National Capital Region, Philippines DELICE FOODS INC. Full time ₱600,000 - ₱800,000 per year

    QUALIFICATIONS:Bachelor's Degree: In Food Science, Food Technology, Microbiology, Chemistry, or a related field.Certification: In Food Safety, Quality Assurance, or HACCP (Hazard Analysis and Critical Control Points).At least 1-3 years in food manufacturing, bakery operations, or quality assurance roles.Familiarity with GMP (Good Manufacturing Practices),...

  • BPO Clinical Review Specialist

    2 weeks ago

    Manila, National Capital Region, Philippines NTT DATA Full time ₱300,000 - ₱600,000 per year

    Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria,...

  • Quality Assurance Specialist

    2 weeks ago

    Manila, National Capital Region, Philippines InvestEd Full time ₱30,000 - ₱60,000 per year

    Duration:Project-based (initial 3–6 months, extendable)Experience Level:At least 2 yearsType:Independent contributorSchedule:Must be able to render at least 20 hours per weekAbout the RoleWe're seeking aQA Specialistwho can independently own the quality assurance process for ongoing projects. You'll focus mainly on manual testing—using strong QA...