Job Description

Pay: ₱40,000.00 - ₱50,000.00 per month

Job description:.

Job Summary

The QA Specialist ensures accuracy, compliance, and integrity of hospital medical coding for inpatient and outpatient records. The role involves auditing coded encounters, validating DRG/APC assignments, and supporting coding teams through education and feedback.

Key Responsibilities

  • Conduct 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 according to AHA Coding Clinic and CMS regulations.
  • Ensure adherence to hospital policies, payer requirements, and regulatory standards. Maintain audit logs, scorecards, and reports.
  • Provide detailed feedback to cod...

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