Outpatient Quality Assurance (Work From Home)

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

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.