Medical Coding Quality Assurance (QA) Specialist – Makati City, Manila, Philippines  

ASP RCM Solutions Inc. – We’re Hiring!

Medical Coding Quality Assurance (QA) Specialist – Makati City, Manila, Philippines

Experience: 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 Summary

The 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 Responsibilities

Audit & Review

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 claims according to AHA Coding Clinic and CMS regulations.

Compliance & Documentation

Ensure adherence to hospital policies, payer requirements, and regulatory standards.

Maintain audit logs and scorecards, and prepare reports for management.

Education & Feedback

Provide detailed feedback to coders based on audit findings.

Recommend educational topics and assist in coder training programs.

Collaboration

Work 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 Improvement

Identify trends, risks, and recommend process improvements.

Stay updated on coding guidelines and reimbursement changes.

Certifications

CCS, CIC, CPC, CPMA or equivalent coding certification required.

Skills

Experience in hospital-based coding audits and denial management

Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT, and DRG/APC assignment

Familiarity with EMR systems and coding tools (e.g., 3M, Optum, Meditech)

Excellent analytical and communication skills

Ability to interpret complex medical documentation and apply coding guidelines accurately

Why Join ASP RCM Solutions Inc.?

Competitive salary package

Stable and growing U.S.-based company

Professional development and skill-building opportunities

Collaborative and supportive work culture

Prime office location

ASP RCM Solutions Inc. – We’re Hiring!

Medical Coding Quality Assurance (QA) Specialist – Makati City, Manila, Philippines

Experience: 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)