Outpatient Coding QA Specialist

R1 RCM PHILIPPINES, INC.; Metro Manila; Remote; PHP 420,000 - 660,000; Full time

Benefits offered by this job

Health insurance

Professional development opportunities

Competitive salary

Job summary

R1 RCM PHILIPPINES, INC. is seeking a Quality Reviewer to conduct internal quality reviews across outpatient coding specialties, focusing on Profee accuracy and performance.

You will identify improvement opportunities, support coder education, and ensure adherence to coding guidelines and payer policies. You will also assist in educating coders, resolving coding issues, and contributing to improvement initiatives while keeping current with industry standards.

Qualifications

• 5+ years of total work experience in outpatient Profee medical coding across multiple specialties.
• At least 1 year of experience as a quality auditor is preferred.
• Currently holds and maintains at least 1 role-related certification (CPC, COC, CCS, CCS-P for outpatient roles; CPMA for auditing).

Responsibilities

• Conduct internal quality reviews across medical coding specialties to assess performance and accuracy.
• Identify areas for improvement, enhance coding efficiency, and provide education to coders.
• Stay up-to-date with official coding guidelines and payer policies; educate coders and resolve coding issues.

Skills

Medical coding

Quality auditing

Compliance awareness

Education

Bachelor's degree in medical allied health

Job description

R1 RCM PHILIPPINES, INC. is seeking a Quality Reviewer to conduct internal quality reviews across outpatient coding specialties, focusing on Profee accuracy and performance.

You will identify improvement opportunities, support coder education, and ensure adherence to coding guidelines and payer policies. You will also assist in educating coders, resolving coding issues, and contributing to improvement initiatives while keeping current with industry standards.