Coding Quality & Audit Lead (Orthopedic/E&M)

PM Consulting; Quezon City; On-site; PHP 1,000,000 - 1,800,000; Full time

Job summary

PM Consulting is seeking an experienced Coding Quality Manager to lead the Coding Quality and Audit team, overseeing coding quality assurance programs, audits, and education to ensure CMS compliance and adherence to official guidelines.

The ideal candidate has extensive orthopedic surgery and/or E/M coding audit expertise, with strong leadership and a deep understanding of ICD-10-CM, CPT, HCPCS, and physician coding compliance.

Qualifications

• Minimum 4 years of coding audit experience in Orthopedic Surgery and/or E/M coding.

Responsibilities

• Lead and manage the Coding Audit and Education team, providing coaching, guidance, and performance oversight.
• Develop, implement, and maintain coding quality assurance and audit programs.
• Conduct coding audits to ensure compliance with CMS regulations, coding guidelines, and organizational policies.
• Identify coding trends, compliance risks, and opportunities for process improvement.
• Develop and deliver coding education and training sessions for providers, coders, and revenue cycle teams.
• Provide coding guidance and serve as a subject matter expert on physician documentation and coding compliance.
• Review and respond to external payer, compliance, and regulatory audits.
• Monitor coding quality metrics and prepare reports for leadership.
• Ensure the team remains current on ICD-10-CM, CPT, HCPCS, CMS regulations, and annual coding updates.
• Collaborate with cross-functional teams to resolve coding and documentation inquiries.
• Drive continuous quality improvement initiatives to enhance coding accuracy and compliance.

Skills

Leadership

Coding audits

Education & coaching

Communication & presentation

Mentoring

Excel proficiency

Education

Health Information Management degree

AAPC certifications (CPC/CPMA/COSC/CEMC)

AHIMA CCS-P/CCS certifications

Tools

Microsoft Office

Job description

PM Consulting is seeking an experienced Coding Quality Manager to lead the Coding Quality and Audit team, overseeing coding quality assurance programs, audits, and education to ensure CMS compliance and adherence to official guidelines.

The ideal candidate has extensive orthopedic surgery and/or E/M coding audit expertise, with strong leadership and a deep understanding of ICD-10-CM, CPT, HCPCS, and physician coding compliance.