medical coding Quality Assurance (qa) specialist - makati city, manila, philippinesASPRCM Solutions Inc.

ASP RCM Solutions Inc. - We're Hiring!Medical Coding Quality Assurance (QA) Specialist - Makati City, Manila, PhilippinesExperience: Minimum 3-5 years hospital coding experience; 1-2 years in QA/auditing preferred
Salary Range: ₱40,000 - ₱50,000 (based on experience and skillset)
Location: Zuellig Building (20th Floor), Makati Avenue corner Paseo de Roxas, Makati City, Philippines
Work Mode: On-site (Work From Office)Job SummaryThe QA Specialist ensures accuracy, compliance, and integrity of hospital medical coding for inpatient and outpatient records. This role involves auditing coded encounters, validating DRG/APC assignments, and supporting coding teams through education and feedback.Key ResponsibilitiesAudit & ReviewConduct retrospective and concurrent audits of hospital-coded records (inpatient, outpatient, day surgery).Validate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes for accuracy and compliance with official guidelines.Review DRG/APC assignments and sequencing claims according to AHA Coding Clinic and CMS regulations.Compliance & DocumentationEnsure adherence to hospital policies, payer requirements, and regulatory standards.Maintain audit logs and scorecards, and prepare reports for management.Education & FeedbackProvide detailed feedback to coders based on audit findings.Recommend educational topics and assist in coder training programs.CollaborationWork with Clinical Documentation Integrity (CDI) teams to resolve mismatched DRGs and improve documentation.Participate in denial management and appeal processes for coding-related issues.Continuous ImprovementIdentify trends, risks, and recommend process improvements.Stay updated on coding guidelines and reimbursement changes.CertificationsCCS, CIC, CPC, CPMA or equivalent coding certification required.SkillsExperience in hospital-based coding audits and denial managementStrong knowledge of ICD-10-CM, ICD-10-PCS, CPT, and DRG/APC assignmentFamiliarity with EMR systems and coding tools (e.g., 3M, Optum, Meditech)Excellent analytical and communication skillsAbility to interpret complex medical documentation and apply coding guidelines accuratelyWhy Join ASP RCM Solutions Inc.?Competitive salary packageStable and growing U.S.-based companyProfessional development and skill-building opportunitiesCollaborative and supportive work culturePrime office locationASP RCM Solutions Inc. - We're Hiring!Medical Coding Quality Assurance (QA) Specialist - Makati City, Manila, PhilippinesExperience: Minimum 3-5 years hospital coding experience, 1-2 years in QA/auditing preferred.
Salary Range: ₱40,000 - ₱50,000 (based on experience & skillset)
Location: Zuellig Building, (20th Floor), Makati Avenue corner Paseo de
Roxas, Makati City Philippines
Work Mode: On-site (Work From Office)Associate / Supervisor Health and Medical Hospital / Health Care 5 openings Bachelor's degree graduateASPRCM SOLUTIONS INC specializes in healthcare revenue cycle management (RCM), offering services such as medical billing, coding, AR calling, and provider credentialing. The company supports hospitals and clinics in optimizing financial operations and compliance. Its team delivers end-to-end RCM solutions to improve efficiency and cash flow.
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Makati City, Metro Manila
₱40,000-50,000 per month
Permanent
Full-time