Supervisor, Quality Analysis (OP Coding, SDS)

Med-Metrix; Pasig; On-site; PHP 558,000 - 781,200; Full time

Job summary

A healthcare quality firm in Pasig, Philippines is seeking an experienced Medical Coding QA Supervisor to lead their quality assurance team. The role requires specialized expertise in Same Day Surgery (SDS) coding, ensuring compliance with regulations, conducting audits, and improving coding accuracy. The ideal candidate has 5+ years of coding experience and relevant certifications like CPC or CCS.

Qualifications

• Minimum 5 years of medical coding experience, with at least 2 years in SDS & Observation.
• 2 years of supervisory or lead experience in QA or auditing role.
• Strong experience with CMS, NCCI edits, and coding guidelines.

Responsibilities

• Supervise daily operations of the coding QA team.
• Conduct internal audits for SDS coding accuracy.
• Develop and maintain coding QA policies and procedures.

Skills

In-depth knowledge of ICD-10-CM

Proficient with EHR and coding software

Analytical and problem-solving skills

Excellent communication and leadership abilities

Attention to detail and commitment to accuracy

Education

Associate or bachelor’s degree in health information management

CPC or CCS certification

Tools

EPIC

3M

Optum

Job description

Supervisor, Quality Analysis (OP Coding, SDS)

Med-Metrix Pasig, National Capital Region, Philippines

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Supervisor, Quality Analysis (OP Coding, SDS)

Med-Metrix Pasig, National Capital Region, Philippines

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Position Summary

We are seeking a detail-oriented and experienced

Position Summary

We are seeking a detail-oriented and experienced Medical Coding QA Supervisor with specialized expertise in Same Day Surgery (SDS) and Observation coding to lead our quality assurance team. The ideal candidate will oversee the auditing task of QAs, ensure compliance with regulations and organizational standards, and support continuous improvement in coding accuracy and productivity. This role requires advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems with a strong focus on SDS procedures.

Key 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, when needed.
• 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.
  
  

Qualifications

Education & Certification:

• Associate or bachelor’s degree in health information management, Health Sciences, or related field preferred.
• Active certification: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent required.
• CPMA certification is preferred but not required.
  
  

Experience

• Minimum 5 years of medical coding experience, with at least 2 years specializing in Same Day Surgery (SDS) & Observation.
• Minimum 2 years of supervisory or lead experience in a QA or auditing role.
• Strong experience with CMS, NCCI edits, and payer-specific coding guidelines.
• IVR experience is preferred but not required.
  
  

Skills & Competencies

• In-depth knowledge of ICD-10-CM, CPT, and HCPCS Level II coding systems.
• Proficient with EHR and coding software (e.g., EPIC, 3M, Optum).
• Exceptional analytical and problem-solving skills.
• Excellent communication and leadership abilities.
• Strong attention to detail and commitment to accuracy and compliance.
• Ability to work independently and as part of a team in a fast-paced environment.
  
  

Preferred Qualifications

• Experience with remote team supervision.
• Previous experience with SDS and Observation coding audits and QA in a multi-specialty or large health system.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  Hospitals and Health Care

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