Coding Quality Review Specialist
Location: Remote
Full-time, Permanent
Work with a team of experts focused on accuracy, integrity, and compliance in medical coding.
Perform internal quality assessment reviews for Health Information Management Service Center (HSC) coders.
Lead and coordinate all functions of coding quality reviews (routine, pre-bill, policy-driven, and incentive plan-driven) for inpatient and outpatient coding across multiple HSCs.
Ensure coding staff adheres to national guidelines, HSC policies, and company coding policies.
Apply expert-level knowledge of medical coding practices and concepts.
Participate in special projects or reviews, maintaining accuracy and productivity standards (95% accuracy, 95% productivity).
Keep coding knowledge current by reviewing official data quality standards, guidelines, policies, and clinical resources.
What will you need?
Undergraduate degree in HIM/HIT preferred (Associate's or Bachelor's).
Active RHIA, RHIT, and/or (mandatory).
Extensive experience auditing MS-DRG inpatient coding:
3+ years of hands-on MS-DRG auditing in a hospital setting.
10+ years of total medical coding experience preferred.
Demonstrated expertise across all body systems (not limited to one specialty, such as Orthopedics).
Ability to pass a coding test: 20 multiple-choice/true-false and 5-7 behavioral questions (90 minutes).
Reside in an eligible state (not available for California, Alaska, New York, or Colorado candidates).
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