Inpatient Coding Quality Analyst - Impactful Medical Coding

Med-Metrix; Metro Manila; Remote; PHP 350,000 - 550,000; Full time

Benefits offered by this job

8-Hour Shifts

Fixed Weekends Off

Day1 HMO with 2 dependents covered for

FREE

Group Life Insurance

Medical Cash Allowance

Rice Allowance

Clothing Allowance

Holiday Gift

Bereavement Assistance

Free Lunch Daily

Paid Time Off

Training and Staff Development

Employee Engagement Activities

Opportunities for Internal Mobility

Job summary

Med-Metrix is seeking a Quality Analyst, Inpatient Coding to review medical coding quality, ensure adherence to CPT/ICD-10-CM, and manage a high-performing coding team.

You will design quality review programs, communicate findings to management, and monitor risk across coding workflows, ensuring accuracy and compliance while supporting professional development.

Qualifications

• Must have medical or allied medical degree or equivalent work experience.
• Hold AAPC and/or AHIMA certification; CPC/MA is an advantage.
• At least 3 years of IP DRG coding experience; proficient with E/M and CPT coding.
• Strong verbal and written communication, analytical skills, and ability to work in a team.

Responsibilities

• Lead and guide team members to meet objectives and uphold culture, policies and procedures.
• Administer quality assessment processes to ensure standards are met.
• Manage daily operations to maintain quality, efficiency and productivity.
• Review reports and data to meet client and company objectives.
• Ensure compliance with HIPAA and maintain documentation of performance targets.

Skills

HIPAA knowledge

CPT/E/M coding

Verbal & written comms

Teamwork & collaboration

Analytical skills

Independence & initiative

Education

Medical/Allied Medical degree

AAPC/AHIMA certification

Job description

Joinourdynamicteamandmakeameaningfulimpactinthehealthcareindustry.You'llplayapivotalroleinensuringaccurateclaimsprocessingwhileadvancingyourcareerinasupportiveandinnovativeenvironment.Enjoycompetitivebenefitsuponhire,ongoingprofessionaldevelopment,andthesatisfactionofhelpingotherseveryday.TakethenextstepinyourcareerwithMed-Metrix!
ExperiencetheseexceptionalbenefitswhenyoujoinMed-Metrix!
8-HourShifts,FixedWeekendsOff
Day1HMOwith2ofyourdependentscoveredforFREE
GroupLifeInsurance
MedicalCashAllowance
RiceAllowance
ClothingAllowance
HolidayGift
BereavementAssistance
FreeLunchDaily
PaidTimeOff
TrainingandStaffDevelopment
EmployeeEngagementActivities
OpportunitiesforInternalMobility

Job Purpose

The QualityAnalyst,InpatientCoding collaborateswithinternalstaffinthedevelopmentofimprovedcapabilitiesintheareasofdocumentation,coding,andcompliance.TheQualityAnalyst,CodingwillassessandreviewtheoverallqualityofcodingonaccountscompletedbyMedicalCoders.TheQualityAnalyst,Coding,ensuresadherencetoworkflowsandethicalcoding.Thepositionrequiresadvancedknowledgeofprofessionalcoding(CPT,ICD-10-CMandHCPCS).

The QualityAnalyst,InpatientCoding isresponsiblefordesigningandimplementingqualitycodingreviewprogramsandcommunicatingreviewfindingsandrecommendationstocodingmanagement.Thepositionobtainsstatisticsandtheinformationnecessarytoassessriskforallareasofcoding.

Duties and Responsibilities

• Setsteamdirection,resolvesproblemsandprovidesguidancetomembersofownteam
• Lead,coach,recognizeanddevelopateamofEmployeesinallaspectsofthejobtomeetobjectivesandmaintaincompanyculture,polices,goalsandprocedures
• AdministertheQualityAssessmentprocesstoensureallqualitystandards/targetscanbemet
• Dailymanagementofalloperationalprocessestoensurethatquality,efficiencyandproductivitystandards/targetsaremet
• Actsasclientcontactforday-to-dayoperationalissuesandstaffassignments.EscalateanyclientconcernsimmediatelytoMedicalCodingManagerorGeneralManager.
• Reviewandanalyzereports,records,anddatatomeetandexceedclientandcompanyobjectives.
• Collaboratewithallworkgroupstoresolveissuesthatimpactinternalandexternalcustomers.
• Rewardinganddiscipliningemployees;addressingcomplaintsandresolvingproblems
• Lookconstantlyfordevelopmentaswellascontinuousimprovementfortheentireteam.
• Ensurethattheemployeesfollowtheirschedulesproperlyasdesigned
• Strivefornewwaystoincreasetheopportunitiesofefficient,accurateworkassignments
• Handlecomplaints,questions,andqueriesasnecessary
• Documentinggeneralreportsoneachteammember'sperformanceandtargetsaswellasensuringthattheyexceedthetargets
• Monitorsystemstoensureoptimalperformance
• Disseminateschangesinguidelinesandrules;monitorchangesinlaws,regulations,andpoliciesthatimpactclinicaldocumentation,reimbursementtoassurecompliance
• Fosteranenvironmentofteamworkandserviceexcellencewithinthedepartment
• Participateinperformanceimprovementactivities
• Assistintheestablishmentof,implementationandmaintenanceofaformalizedreviewprocesstoensurecompliancewithcontractualagreementsregardingaccuracyrates
• Assistinthecreation,monitoringandstandardizationofcompanypoliciesandprocedurestomonitorthesuccessofthedataqualitymanagementplan,reviewourandourclientsareasofrisk,investigateidentifiedissues,reportdataanalysesandtakeappropriatestepstocorrectanyviolations.MakerecommendationstoensurethehighestcomplianceratewiththeMed-Metrixqualitymanagementplan
• Participateinconferencecalls/meetingswithmanagementandstafftoensureallperformanceandtrainingrecommendationsareaddressedandimprovementsuggestionsareimplemented
• Assistinnewhiretrainingclasses,transitionperiodsandrefreshertrainingsasneeded
• Knowledgeof,understandingof,andcompliancewithallMed-Metrixpoliciesandprocedures
• Providefeedbacktomanagementconcerningpossibleproblemsorareasofneededimprovement
• Use,protectanddisclosepatients'protectedhealthinformation(PHI)onlyinaccordancewithHealthInsurancePortabilityandAccountabilityAct(HIPAA)standards

Qualifications

• GraduateofanyMedicalorAlliedMedicalcourseorhasequivalentworkexperience
• HoldAAPCand/orAHIMAcertification.CPMAisanadvantage
• Atleast3yearsofIPDRGCoding
• ProficientwithE/MandCPTProcedurecoding
• Abilitytoworkinateamfosteredenvironmentandhavethewillingnesstoadjusttochangingjobresponsibilities,shiftingschedules,newproceduresandunexpectedworkloadsandstresses
• Possessstrongverbal,writtencommunication,interpersonalskillsandanalyticalskills
• Willingnessandflexibilitytoworkextendedhours
• Assertiveself-starterwhocanworkindependently,yetfunctioninateamenvironment
• Abilitytoplanwellandprioritizeworkandmaintaincalmnessunderpressure
• AnunderstandingandstrictadherencetoallHIPAAregulations

Minimum of six (6) months experience with exceptional performance in chosen area of quality management Medical Coding - demonstrated HIPAA knowledge required

Abilitytoworkinateamfosteredenvironmentandhavethewillingnesstoadjusttochangingjobresponsibilities,shiftingschedules,newproceduresandunexpectedworkloadsandstresses

Working Conditions

WorkSet-Up:WorkFromHome

WorkSchedule:Dayshift

PhysicalDemands:Whileperformingthedutiesofthisjob,theemployeeisoccasionallyrequiredtomovearoundtheworkarea;Sit;performmanualtasks;operatetoolsandotherofficeequipmentsuchascomputer,computerperipheralsandtelephones;extendarms;kneel;talkandhear

MentalDemands:Theemployeemustbeabletofollowdirections,collaboratewithothers,andhandlestress

WorkEnvironment:Thenoiselevelintheworkenvironmentisusuallyminimal

Med-Metrixwillnotdiscriminateagainstanyemployeeorapplicantforemploymentbecauseofrace,color,religion,sex(includingpregnancy,genderidentity,andsexualorientation),parentalstatus,nationalorigin,age,disability,geneticinformation(includingfamilymedicalhistory),politicalaffiliation,militaryservice,veteranstatus,othernon-meritbasedfactors,oranyothercharacteristicprotectedbyfederal,stateorlocallaw