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Open nowPosted 245 days ago

Home Health Medical Coding QA Specialist

Pointwest13 open roles

Where
Quezon City, Philippines
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Your applicationOpen nowHome Health Medical Coding QA SpecialistPointwest · Quezon City, Philippines

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  2. CV RocketCV written for this posting.

  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

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The clock on this job

Early applications get read.

12.3% of postings close within 7 days. Measured by our own scanner across the market.

Share of postings closed within
  1. 2.1%1 day
  2. 4.5%3 days
  3. 12.3%7 days
  4. 19.3%14 days
  5. 35.6%30 days
  6. 58.1%60 days
This job: posted 245 days ago

The posting

We are looking for a detail-oriented Quality Control for Coding Specialist to ensure the accuracy, compliance, and consistency of medical coding and billing practices. This role plays a vital part in maintaining the integrity of health data and optimizing the revenue cycle by implementing internal audits, reviews, feedback processes, and continuous improvement initiatives. You’ll be part of a team committed to Leadership, Excellence, Innovation, and a culture of Agility, Accountability, Collaboration, and Customer Centricity.

Key Responsibilities

Delighting Our Customers & Stakeholders

  • Ensure coding accuracy using ICD-10, CPT, and applicable guidelines
  • Perform internal audits and peer reviews
  • Validate clinical documentation supports coded entries
  • Enforce compliance with HIPAA and payer requirements

Growing Our Business

  • Reduce coding-related denials and rejections
  • Support revenue cycle optimization through timely audits
  • Recommend process enhancements and tools for better accuracy
  • Contribute insights to client engagement and support activities

Improving the Way We Work

  • Use audit tools and QC platforms to automate checks
  • Maintain and update audit protocols and workflows
  • Analyze data trends to address recurring issues
  • Collaborate across departments for process alignment

Developing Myself and Others

  • Provide feedback and coaching to coding team members
  • Lead or join training sessions on compliance and coding standards
  • Stay updated on industry guidelines and certifications
  • Promote a quality-first, learning-driven culture

Key Metrics

  • ≥ 95% coding accuracy rate
  • ≥ 90% clean claims rate
  • ≤ 5% documentation-related coding error rate
  • ≥ 20% YOY reduction in coding-related denials
  • ≥ 90% adherence to QC protocols and audit schedules
  • ≥ 2 professional development activities per year

Qualifications

  • Degree in Health Information Management, Nursing, or related field
  • Certified Professional Coder (CPC), CCS, or equivalent
  • 2–3 years’ experience in medical coding and quality control
  • Knowledge of ICD-10, CPT, HCPCS, CMS, and payer-specific guidelines
  • Proficiency in medical coding software and audit platforms
  • Strong analytical, communication, and collaboration skills

Join us in redefining healthcare excellence—one accurate code at a time. Apply now and be part of a team committed to quality, innovation, and continuous improvement.

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