Demo

Coding Quality Review Specialist

Talently
Nashville, TN Full Time
POSTED ON 11/6/2025
AVAILABLE BEFORE 12/5/2025

Job Title: Coding Quality Review Specialist

Location: Remote

Salary: $85,000 depending on experience

Skills: Auditing, Inpatient Coding, DRG Validation, Quality Review


About the Company / Opportunity:

Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices. This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity. Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.


Responsibilities:

  • Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.
  • Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance with established guidelines and policies.
  • Support coding staff adherence to national coding guidelines and company policies through audits and targeted feedback.
  • Apply expert-level knowledge of medical coding practices to identify areas for improvement and provide education to coding staff.
  • Participate in special projects or reviews as needed to support continuous quality improvement.
  • Maintain or exceed productivity and accuracy standards (95% ).
  • Stay current on official data quality standards, coding guidelines, and ongoing educational requirements.


Must-Have Skills:

  • CCS, RHIA, and/or RHIT (mandatory).
  • At least 10 years of hospital medical coding experience, with a minimum of 3 years auditing MS-DRG Inpatient medical records.
  • Demonstrated expertise as an IP Coding Auditor with advanced MS-DRG auditing experience.
  • Proven experience coding across all body systems (not limited to specialty areas).
  • Strong understanding of official coding guidelines, data quality standards, and hospital coding compliance.


Nice-to-Have Skills:

  • Undergraduate degree in Health Information Management (HIM) or Health Information Technology (HIT) (Associate's or Bachelor's preferred).
  • Experience participating in special quality review projects or process improvement initiatives.
  • Background supporting multi-site health systems or large-scale coding review teams.
  • Familiarity with remote work tools and distributed team collaboration.
  • Ongoing commitment to professional development and continuous education in medical coding.

Salary : $85,000

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