- Location
- Metro Manila, Quezon City
- Type
- Contract
- Department
- Healthcare
- Source
- Freshteam
Description
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