Outpatient Quality Assurance

R1 RCM, Inc.; Metro Manila; On-site; PHP 600,000 - 900,000; Full time

Benefits offered by this job

Health Insurance (HMO on Day 1)

Competitive pay

Professional development opportunities

Job summary

R1 RCM PHILIPPINES, INC. seeks a Quality Reviewer to conduct internal quality reviews across medical coding specialties, improving accuracy and efficiency. You will educate coders, resolve coding issues, and support improvement initiatives while staying current with coding guidelines and payer policies.

The role emphasizes mentoring, identifying gaps, and driving education programs to ensure compliance and high performance in outpatient Profee coding.

Qualifications

• At least 5 years of total work experience in medical coding for outpatient Profee settings with exposure to multiple specialties (coding or auditing for Profee (E/M IP & E/M OP)
• At least 1 year of experience as a quality auditor is preferred.
• License/Certifications: Currently holds and maintains at least 1 role-related certification (CPC, COC, CCS, CCS-P for outpatient roles, CPMA for auditing role).
• Education – Bachelor’s degree in a medical allied course is preferred. For other courses, a high level of knowledge and relevant work experience to illustrate capability.

Responsibilities

• Conduct internal quality reviews across medical coding specialties to assess coder performance and coding accuracy.
• Identify areas for improvement, enhance coding efficiency, and provide educational opportunities.
• Assist in educating coders, resolving coding issues, and driving improvement initiatives.
• Stay up to date with official coding guidelines and payer policies.

Skills

Medical coding

Auditing

Quality review

Education training

Education

Bachelor’s degree in medical allied course

Job description

Join the leading healthcare revenue cycle management provider as a Outpatient QA and earn Competitive pay, HMO on Day 1, and more!

As a 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.

Qualifications:

• At least 5 years of total work experience in medical coding for outpatient Profee settings with exposure to multiple specialties (coding or auditing for Profee (E/M IP & E/M OP)
• At least 1 year of experience as a quality auditor is preferred.
• License/Certifications: Currently holds and maintains at least 1 role-related certification (CPC, COC, CCS, CCS-P for outpatient roles, CPMA for auditing role).
• Education – Bachelor’s degree in a medical allied course is preferred. For other courses, a high level of knowledge and relevant work experience to illustrate capability.

What we offer

R1 RCM PHILIPPINES, INC. provides a competitive salary and a comprehensive benefits package, including health insurance and opportunities for professional development. Our company culture is focused on collaboration, innovation, and a commitment to excellence in healthcare revenue cycle management.

About us

R1 RCM PHILIPPINES, INC. is a leading provider of revenue cycle management services for healthcare organizations. With a strong focus on technology and innovation, we partner with our clients to optimize their financial performance and improve the patient experience. Our team of dedicated professionals is driven by a shared mission to transform healthcare through intelligent revenue cycle solutions.

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