IP/PB Clinical Quality Assurance Specialist

4 days ago

Quezon City, National Capital Region, Philippines R1 RCM Full time

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).

PB 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.

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