Medical Coding QA Supervisor
- Pasig City, Metro Manila
- ₱65,000 per month
- Permanent
- Full-time
- Oversee day-to-day activities of the coding QA team, with a specific focus on audits for SDS and Observation services.
- Conduct spot checks or in-depth reviews when necessary to evaluate coding accuracy and consistency.
- Track and assess team performance using established QA metrics; provide feedback and corrective guidance to maintain coding standards.
- Develop and refine internal QA protocols, audit methodologies, and documentation procedures in line with organizational and industry standards.
- Work with training and education teams to identify learning gaps and facilitate ongoing coder development.
- Serve as the subject matter expert (SME) for SDS and Observation-related coding issues, offering support on escalations and complex cases.
- Ensure all coding activities are aligned with federal regulations, CMS guidelines, payer-specific rules, and internal policies.
- Prepare clear, data-driven audit reports and trend analyses for leadership to support strategic quality initiatives.
- Stay current on updates in coding standards, payer guidelines, CMS regulations, and compliance requirements.
- Assist in recruitment, onboarding, coaching, and performance evaluations of QA staff.
- Provide QA support on special coding projects, workflow transitions, or technology implementations.
- Associate or Bachelor’s degree in Health Information Management, Health Sciences, or a related field (preferred).
- Active coding certification required: CPC, CCS, or an equivalent credential.
- CPMA certification is a plus.
- At least 5 years of hands-on coding experience, including a minimum of 2 years focused on SDS and Observation services.
- Minimum 2 years in a QA lead, supervisory, or auditing role.
- Familiarity with CMS guidelines, NCCI edits, and payer-specific coding policies.
- Experience with IVR systems is a bonus.
- Proficient in ICD-10-CM, CPT, and HCPCS Level II coding systems.
- Skilled in using EHR and coding platforms (e.g., Epic, 3M, Optum).
- Strong analytical, documentation, and problem-solving capabilities.