In-Patient Coding Quality Assurance Specialist

6 days ago

Pasig, National Capital Region, Philippines Nexus Recruitment Group Full time


Job Summary:

We are looking for a meticulous and experienced In-Patient Coding Quality Assurance (QA) Specialist to ensure the accuracy, consistency, and compliance of inpatient coding assignments. This role is critical in maintaining coding standards and ensuring that documentation and coding meet regulatory and client-specific requirements. The ideal candidate brings deep expertise in inpatient coding, a strong grasp of auditing practices, and a commitment to continuous improvement.

Key Responsibilities:
  • Perform retrospective and concurrent audits of inpatient coded records to validate accuracy, completeness, and adherence to official coding guidelines.
  • Provide detailed feedback and education to coding teams based on audit findings.
  • Identify trends or recurring issues in coding accuracy and recommend corrective actions or training.
  • Collaborate with internal teams to refine coding workflows and ensure documentation supports code assignments.
  • Maintain audit logs, scorecards, and reporting metrics as required by internal and client guidelines.
  • Stay current on inpatient coding updates, payer requirements, and regulatory changes (e.g., CMS, OIG).
  • Assist with new coder onboarding QA reviews and periodic competency assessments.
Qualifications:
  • Associates or Bachelors degree in Health Information Management, Nursing, or a related field preferred.
  • Active CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification required.
  • Minimum 3-5 years of inpatient coding experience, with at least 1-2 years in a QA or auditing role.
  • Strong knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG/APR-DRG assignment, and official coding guidelines.
  • Experience using EMR systems and coding tools (e.g., 3M, Optum).
  • Familiarity with HIPAA and quality management standards in healthcare documentation.
Preferred Skills:
  • Background in quality review for coding across multiple provider types or health systems.
  • Excellent analytical, communication, and documentation skills.
  • Ability to manage audit schedules, meet deadlines, and adapt in a fast-paced environment.
  • Experience with education and training in coding best practices is a plus.

  • Quality Assurance Specialist

    4 days ago

    Pasig, National Capital Region, Philippines GICF Full time

    Company DescriptionGlobal Integrated Contact Facilities, Inc. (GICF) is a flexible and competitive IT-BPM (BPO) company that partners with clients to develop customized solutions aimed at maximizing their goals and bottom-line. GICF has over 1000 employees and a successful history of managing cost-effective, multi-channel contact center and back-office...

  • Coding Denials Specialist

    6 days ago

    Pasig, National Capital Region, Philippines Private Advertiser Full time

    About the jobCoding Denial Representative is responsible to review payor's denial and identify the root cause of the denials account. Coding Denial Representative determines if the account is appealable or not.Coding Denial Representative must understand and comply with the process established by the Federal and State regulations, Payor's specific...

  • Coding Denials Specialist

    1 week ago

    Pasig, National Capital Region, Philippines Coronis Health Full time

    Coding Denial Representative is responsible to review payor's denial and identify the root cause of the denials account. Coding Denial Representative determines if the account is appealable or not.Coding Denial Representative must understand and comply with the process established by the Federal and State regulations, Payor's specific guidelines, Official...

  • Quality Analyst, Inpatent Medical Coding

    1 week ago

    Pasig, National Capital Region, Philippines Med-Metrix Full time ₱1,500,000 - ₱3,000,000 per year

    Join our dynamic team and make a meaningful impact in the healthcare industry. You'll play a pivotal role in ensuring accurate claims processing while advancing your career in a supportive and innovative environment. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others every day. Take the next step in...

  • In-Patient Medical Coder

    6 days ago

    Pasig, National Capital Region, Philippines Nexus Recruitment Group Full time

    Job Summary:We are seeking a detail-oriented and experienced In-Patient Medical Coder to support accurate and compliant coding of inpatient medical records. The role involves reviewing clinical documentation and assigning appropriate diagnosis and procedure codes to ensure timely and accurate billing processes. The ideal candidate has a strong command of...

  • Out-Patient Medical Coder

    6 days ago

    Pasig, National Capital Region, Philippines Nexus Recruitment Group Full time

    Job Summary:We are hiring a skilled and reliable Out-Patient Medical Coder to ensure accurate and compliant coding of outpatient medical records. This role involves reviewing clinical documentation and applying appropriate CPT, HCPCS, and ICD-10-CM codes across a variety of outpatient settings and specialties. The successful candidate will demonstrate solid...

  • People Quality Assurance and Test Senior Specialist

    2 days ago

    Pasig, National Capital Region, Philippines Converge ICT Solutions Inc. Full time

    Job Purpose:The People Quality Assurance and Test – Senior Specialist plays a critical role in ensuring the quality, reliability, and efficiency of the People & Culture (P&C) operations, processes, and technology ecosystem. This position is responsible for establishing and executing a robust Quality Assurance (QA) framework, driving continuous process...

  • quality assurance supervisor

    1 week ago

    Pasig, National Capital Region, Philippines PH Global Jet Express Full time ₱900,000 - ₱1,200,000 per year

    QA Supervisor is a specialist in preventing operational errors by ensuring that the SOPs are strictly implemented in order to prevent misoperations or problematic parcels.  He/she is concerned with the proactive procedural process of J&T Operations (both internal and external).  Anticipates periods of problem occurrence and proposes plans to address those,...

  • Jr. Quality Assurance Engineer

    2 weeks ago

    Pasig, National Capital Region, Philippines IThinkWeb Corporation Full time ₱300,000 - ₱500,000 per year

    Jr. Quality Assurance Engineer is responsible in conducting software testing and quality assurance for applications.Duties and Responsibilities:Develop test cases based on the test design •Create functional test plans and test designs for the product or feature under testWorks with project team and ensures quality of assigned applicationsMaintains and...

  • Quality Assurance Manager

    1 week ago

    Pasig, National Capital Region, Philippines weSource Management Consultancy Firm Full time ₱100,000 - ₱200,000 per year

    We are looking for a Quality Assurance Manager for our client in Ortigas, PasigSchedule: Mon to FriSalary: up to 100kSet-up: Hybrid (2x-3x onsite work per week)Industry: AuditingPOSITION/ROLE SUMMARYThe person will participate in quality improvement programs and contribute heavily in areas related to continuous process improvement. The position reports to...