Medical Coding QA Lead – SDS & Observation

Med-Metrix, LLC; Pasig; On-site; PHP 800,000 - 1,100,000; Full time

Job summary

Med-Metrix, LLC is seeking a detail-oriented Medical Coding QA Supervisor with SDS and Observation expertise to lead the QA team and ensure auditing accuracy in a fast-paced Manila setting.

The ideal candidate will hold CPC or CCS certification, 5+ years in medical coding with SDS focus, and 2+ years in a supervisory QA role, with strong knowledge of CMS guidelines and payer policies.

Qualifications

• Minimum 5 years of medical coding experience, with at least 2 years specializing in SDS & Observation.
• Active CPC or CCS certification required; CPMA preferred.
• Experience supervising or leading QA/auditing teams is essential.

Responsibilities

• Supervise daily operations of the coding QA team, specifically SDS & Observation audits.
• Conduct internal audits to evaluate accuracy, consistency, and regulatory compliance in SDS coding.
• Monitor coding performance and quality metrics; provide actionable feedback to improve team effectiveness.
• Develop, implement, and maintain coding QA policies and procedures in collaboration with leadership.
• Collaborate with coding education staff to identify training needs and deliver targeted education based on audit findings.
• Act as a subject matter expert for SDS & Observation coding questions and escalated cases.
• Ensure coding practices align with federal guidelines, payer-specific policies, and organizational goals.
• Provide detailed reporting and analysis of audit results to leadership, identifying trends and risks.
• Maintain up-to-date knowledge of coding standards, CMS regulations, payer guidelines, and industry best practices.
• Participate in hiring, onboarding, and mentoring QA.
• Support coding projects, system upgrades, and other initiatives as assigned.

Skills

Quality Assurance

Medical Coding

Leadership

CMS guidelines

Education

Associate or Bachelor's in Health Information Management / Health Sciences

Active CPC/CCS certification

Tools

EPIC

3M Coding

Optum

Job description

Med-Metrix, LLC is seeking a detail-oriented Medical Coding QA Supervisor with SDS and Observation expertise to lead the QA team and ensure auditing accuracy in a fast-paced Manila setting.

The ideal candidate will hold CPC or CCS certification, 5+ years in medical coding with SDS focus, and 2+ years in a supervisory QA role, with strong knowledge of CMS guidelines and payer policies.